Perthes disease is a disease of the hip joint in children. The ball-shaped top (head) of the thigh bone (femur) and the cup-shaped hip socket, called the acetabulum. Perthes disease is a disease of the hip joint in children. consequently leads to changes in the femoral head, metaphysis, growth plate, and acetabulum.
In Perthes disease, the head of the femur loses its blood supply and part of the bone dies. The bone becomes weak and a small break (fracture) develops. This causes the bone to change shape so that it no longer fits into the hip joint socket properly.
The reason for the temporary loss of blood supply is unclear. It appears that some children, have a sensitive blood supply to the hip and that blood flow is somehow temporarily blocked. With loss of blood supply, the bone in the ball (femoral head), actually dies.
It is a disease mostly affecting children between 2 to 12 years old. It occurs 4 times more often in boys than girls and is associated with a low birth weight, especially boys less than 5.5 pounds. About 1 in 5 children with Perthes disease have another family member with the disease.
The first symptoms are a limp, occasional knee pain and stiffness. Some of the child’s movements are reduced. “Doing the splits” is the first movement in which tightening up is noticed. The muscles of the affected leg may get smaller as well.
The first presenting complaint is limping that is usually notice by parents. The second common complaint is pain mostly in the anterior hip and medial thigh, which may lead to antalgic gait. Range of hip motion may be affected with abduction and internal rotation being limited first, followed by a trendelenburg gait. In severe cases, adduction contracture may form.
Perthes disease
