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Perthes disease

Perthes disease is a painful condition of the hip. It is also sometimes called Legg-Calve-Perthes disease, or coxa plana, or avascular necrosis of the hip.

Perthes disease usually occurs in children. It takes time, but most children recover fully.

What is Perthes disease?

Perthes disease is a problem with the blood supply to the top of the thighbone, or femur. The top of the femur is a ball, sometimes called the femoral head.

The femoral head fits into a socket in the pelvis to form the hip joint. It is called a ball and socket joint.

In Perthes disease, the femoral head becomes soft and goes out of shape. This causes pain and a limp.

Causes of Perthes disease

It is not clear why the blood supply to the femoral head is reduced.

Perthes disease usually affects children aged from 3 to 11 in one hip. In some cases, it affects both hips, and it sometimes runs in families.

Symptoms of Perthes disease

Symptoms of Perthes disease include:

  • pain in the hip, knee or groin
  • a slight limp that becomes worse over time
  • limited movement.

Diagnosis of Perthes disease

If your child has pain in the hip, your doctor may suggest an x-ray to diagnose Perthes disease. If the x-ray doesn’t provide an answer, other more sensitive tests can include:

Treatment of Perthes disease

If your child has Perthes disease, he or she will probably be referred to a specialist.

The bone will repair itself, as long as it is not too damaged. This takes time, usually between 1 and 5 years.

The aim of treatment is to avoid making it worse. This might include:

  • avoiding activities with a high impact on the hip, such as running
  • rest and use of a wheelchair or crutches
  • a splint or a plaster
  • special exercises.

A few children will need surgery.

Last reviewed: February 2016

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