perthes Disease

In this condition the blood supply to the hip joint (ball) decreases on its own leading to inflammation and edema. This condition is typically seen in children around 7 years of age. The child may complain of limp and occasional pain. There is inability to sit cross legged. There are 4 stages of this disease. The child may have history of steroid use for conditions like asthama. Some parents also give history of hyperactivity in the child. The diagnosis is usually on radiographs.

Radiograph showing Perthes disease of left hip

Treatment

Non surgical: in early stages of the disease and in mild cases the child is given analgesics and advised rest. Children less than 6 years and those without progression usually do well with this method.

Surgical:

If the head lesions are progressing then we need to operate the hip joint to preserve its congruity. Usually the hip bone is cut and plate is applied to hold the bone in plate. If surgery is performed at an appropriate time then long term results of this condition are very good. A delay in treatment can lead to the head forming an abnormal shape and the child will suffer from hip pain at an older age.

Radiograph showing Perthes disease of left hip
Radiograph showing plate fixation and varus osteotomy
Clinical photo showing squatting
Clinical photo showing sitting cross legged