Perthe's disease

Kids Orthopaedic

Dr. Soumya Paik Phone No. : +91 9051 148 463

Perthes disease is a rare childhood hip disorder which affects children from the age group of four to twelve years. The disease affects a child’s hips when blood supply is interrupted to the ball or rounded head of the femur (thigh bone) temporarily. The inadequate blood supply makes the bone cells die gradually. Hence, perthes disease normally lasts for a number of years. As the condition persists, the child’s femur starts breaking apart.

However, the bone start growing once blood supply to the femur commences and normalizes.

What causes Perthes' disease?

While the mechanism for bone degeneration is known to be loss of blood supply to the hip joint, the precise cause of the blood loss is not known. Several theories exist, including one that abnormal blood clotting blocks the small arteries to the joint. Another is that the main artery to the femoral head closes too early, perhaps as a result of injury or malnutrition.

Genetics may be involved, since the condition is five times more likely to affect boys - this link has not been proven, however.

What are the symptoms of Perthes' disease?

Initially, mild pain and limping are the symptoms, experienced over a period of months. The muscles around the hip joint may spasm to increase the pain. The pain is worsened when the hip is moved. Occasionally, the pain may be felt in the knee joint or the groin area.

How is Perthes' disease diagnosed?

The pain is an indicator of the condition. Together with history, a physical examination of movements causing pain help to establish a diagnosis. X-rays are however the primary method for confirming diagnosis. An MRI-scan is not necessary, but can establish the degree of deformity.

How is Perthes' disease treated?

Treatment is based around avoiding degenerative arthritis later in life. There is no cure for Perthes' disease and so the focus of treatment is management, and allowing the femoral head to grow normally and without deformity. This may involve the prescription of pain medication, but primarily focuses on removing pressure on the hip joint, by means of several things: the use of crutches when walking, bed rest, and traction in some cases. Antiinflammatory medications are used to reduce the inflammation around the bone. In time, physical exercises can be introduced to develop strength in the affected area. In some cases, especially with older children, surgery is an option to realign the hip joint.

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