Perthes Disease

Overview

Perthes disease is a childhood hip condition in which the blood supply to the femoral head (the ball of the hip joint) is temporarily disrupted, causing the bone to weaken and gradually collapse. Over time, the bone may regenerate, but the shape of the hip joint can be affected.

The condition is also known as Legg‑Calvé‑Perthes Disease and most commonly affects children between 4 and 10 years of age.

Early diagnosis and treatment are important to preserve the shape of the hip joint and maintain normal hip movement.

At Moolchand Hospital, a leading multi super speciality hospital in Delhi, pediatric orthopedic specialists provide comprehensive care for children with hip disorders including Perthes disease.

What is Perthes Disease?

The hip joint is a ball-and-socket joint formed by:

• The femoral head (ball)
  
  

• The acetabulum (hip socket)
  
  

In Perthes disease:

• Blood supply to the femoral head temporarily decreases
  
  

• The bone becomes weak and may collapse
  
  

• New bone gradually forms as the blood supply returns
  
  

The healing process may take several years, and treatment focuses on maintaining proper hip joint alignment.

Symptoms of Perthes Disease

Symptoms often develop gradually.

Common symptoms include:

• Limping while walking
  
  

• Pain in the hip, groin, thigh, or knee
  
  

• Reduced hip movement
  
  

• Stiffness in the hip joint
  
  

• Difficulty with physical activities
  
  

Pain may worsen during activity and improve with rest.

Causes

The exact cause of Perthes disease is not fully understood.

Possible factors include:

• Temporary interruption of blood supply to the femoral head
  
  

• Genetic predisposition
  
  

• Abnormal bone growth
  
  

• Minor repeated trauma
  
  

However, many children with Perthes disease have no identifiable cause.

Risk Factors

Certain factors increase the risk of Perthes disease:

• Age between 4 and 10 years
  
  

• Male gender (more common in boys)
  
  

• Family history of the condition
  
  

• Low birth weight or delayed skeletal development
  
  

Diagnosis

Doctors diagnose Perthes disease using clinical evaluation and imaging studies.

Physical Examination

Doctors assess:

• Hip movement
  
  

• Walking pattern (gait)
  
  

• Leg length differences
  
  

Imaging Tests

• X-rays to detect changes in the femoral head
  
  

• MRI scans to identify early bone damage
  
  

• Bone scans in selected cases
  
  

At Moolchand Hospital Delhi, advanced imaging helps detect Perthes disease early and guide treatment.

Treatment Options

Treatment depends on the child’s age and severity of the condition.

Activity Modification

Limiting high-impact activities helps reduce stress on the hip joint.

Physiotherapy

Exercises maintain hip flexibility and muscle strength.

Bracing

Special braces may help keep the femoral head properly positioned in the hip socket.

Medications

Pain-relieving medications may help manage symptoms.

Surgical Treatment

In severe cases, surgery may be required to improve hip joint alignment.

Possible Complications

If untreated, Perthes disease may lead to:

• Hip joint deformity
  
  

• Reduced hip movement
  
  

• Leg length differences
  
  

• Early hip arthritis in adulthood
  
  

Early treatment significantly improves outcomes.

Prevention

Perthes disease cannot always be prevented, but early recognition can reduce complications.

Parents should seek medical evaluation if a child develops:

• Persistent limp
  
  

• Hip or knee pain