Perthes Disease


Article by J. MillerS.Armfield

Perthes Disease

What is Perthes Disease?

Legg-Calve-Perthes Disease, or Perthes Disease for short, is a rare condition that affects children. It affects boys more than girls and usually between the ages of 4-10 years old. It affects the hip joint and involves the femoral head (the ball part at the top of the thigh bone). The blood supply to this area of the bone becomes interrupted, with insufficient blood flow the bone begins to die (avascular necrosis). This results in a flattening of the femoral head. In most cases, this only occurs on the one side. 

What Causes Perthes Disease?

Perthes is caused by the interruption of blood flow as explained above. The cause of this interruption remains unknown.

What are the Symptoms of Perthes Disease?

Symptoms of Perthes disease include:

  • Limping- may or may not be related to pain
  • Hip joint stiffness
  • Pain in the hip, groin, thigh or knee
  • Decreased range of movement of the hip
  • Shortening of the affected leg
  • Atrophy (wasting) of the surrounding muscles

How is Perthes Disease Diagnosed?

Clinical examination findings include an observable limp with walking and decreased hip joint range of motion.

An X-ray may show the flattening of the femoral head, often in the initial stages changes cannot be seen on an X-ray but may be demonstrated by successive x-rays. At times an MRI or bone scan may also be required.

Perthes Disease Treatment

For children under the age of 6 treatment is usually conservative and doesn’t require surgery. This is because they are young and their bones still have a lot of growing and developing and the femoral head has more time to repair. Conservative management is where you physiotherapist can assist. Your child will require rest from high-intensity activities including running to prevent further damage to the hip joint.

Physiotherapy treatment will involve:

  • Advice and education on the condition and providing recommendations on relevant rest to assist with decreasing pain
  • Stretching exercises for the hip
  • Progressive strengthening exercises for the hip and leg
  • Crutches to decrease weight-bearing if walking is particularly sore

At times conservative treatment may also involve traction, where the hip is gently pulled out from the socket to help relieve pain; or casting to maintain femoral head alignment.

Surgery may be required in more severe cases. Surgery is aimed at improving joint alignment and the contour of the femoral head. Surgical methods range from releasing tight muscles around the hip to joint realignment. Post surgery, your physiotherapist can help to provide stretching and strengthening exercises to assist with recovery and a return to activity.

Perthes Disease Prognosis

Sometimes those who have had Perthes disease require a joint replacement later in life. Children who have had Perthes are also more likely to develop early onset of hip arthritis.

Your physiotherapist can aid in the detection and diagnosis of Perthes disease. If your child has or has had Perthes, the physiotherapy team at PhysioWorks has the ability to help your child get back into normal activities and sport, and simply be a child again.

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Common Hip Treatments

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Acupuncture and Dry Needling
  • Core Exercises
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Real Time Ultrasound Physiotherapy
  • Soft Tissue Massage
  • Brace or Support
  • Bursitis Treatment
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Kinesiology Tape
  • Prehabilitation
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • Call PhysioWorks

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    Related Injuries

    General Information

    Hip Joint Pain

    Lateral Hip Pain

    Adductor-related Groin Pain

    Pubic-related Groin Pain

    Inguinal-related Groin Pain

    • Inguinal hernia
    • Sportsman's hernia

    Iliopsoas-related Groin Pain

    • Hip Flexor Strain

    Other Muscle-related Pain

    Systemic Diseases

    Referred Sources

    Hip Surgery

    FAQs about Perthes Disease

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • How Can You Prevent a Future Leg Injury?
  • How Much Treatment Will You Need?
  • Sports Injury? What to do? When?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • Call PhysioWorks

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    Last updated 14-Feb-2019 10:48 AM

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