• 25 FEB 18
    • 0

    Perthes Disease

    It manifests in limping and hobbling in children. Early diagnosis is essential in the treatment of Perthes, which is observed 5 times more in boys, compared to girls.

    Risk Factors in Perthes Disease

    Perthes disease is caused by disturbed blood circulation in the round top of the femur bone. Manifesting in ages 4 to 8, this disease is seen in 1 child in every 10,000. Perthes generally occurs in only one joint. Occasionally it can be seen in both joints. Since it can be mixed with other diseases, attention shall be paid during diagnosis. The cause of the disease is not known. However, research reveals that, although the causation is not clear, below predispositions create risk of catching Perthes disease:

    • Attention deficit and hyperactivity disorder
    • Countries with lower socio-economic levels
    • Family history of Perthes disease
    • European and Asian races
    • Birth with low birth weight
    • Being present in smoking areas (passive smoking)

    Symptoms of Perthes Disease

    Perthes manifests with pain in the thigh and hip, limping, hobbling. These may be mild or very severe in some cases. Very rarely, leg shortening can be seen. Therefore it is important to consult to a paediatric orthopaedist without delay when the child regularly mentions pains or starts limping.

    Diagnosis Methods for Perthes Disease

    X-ray can be taken along with physical examination of patients. Generally it is possible to diagnose with x-ray. In very early ages problems may not be seen in x-rays. Therefore, another x-ray shall be taken for control if the pain of the child persists. Although generally only x-ray is sufficient, in some cases the paediatric orthopaedist may recommend MR of scintigraphy.

    Treatment of Perthes Disease

    Treatment of Perthes disease depends on the age of the patient and the degree of the disease. When the disease is diagnosed in early stages, carpal age is below 6 and joint movements are open, child shall be monitored by a paediatric orthopaedist. Activities of the child are restricted in the treatment. Although allowed to step on the child is not allowed to engage in sportive activities. In case the pain intensifies, rest is recommended and pain is removed after this period.

    The main aim of the treatment of Perthes disease is to preserve the openness of the joint to movements. Thus the head of the femur is allowed to develop in a spherical form.  Treatment of Perthes diseases continues until the bone development of the child is completed. After recovery, there are no problems in early adulthood. But tophus can be seen in the hip in ages of 50s or 60s.

    Perthes is observed in 4 stages. Patients observe first symptoms and consult a doctor generally in stage two. When progressing from stage three to four, necrosis is observed in part or whole of the femur head bone. Body creates new bones instead of dead tissues. The aim of the treatment in restructuring stage is to keep the head of the femur inside the socked of the hip joint.

    For this purpose, paediatric surgeon may employ surgical operations when deemed necessary. In some cases that are diagnosed late or detected in advanced stages, monitoring physiotherapy protocol can be opted for treatment and the child is prepared for surgical treatments in later ages.


    Contents of the page are for information purposes only, you must consult your doctor for diagnosis and treatment.