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Perthes Disease (Legg-Calve-Perthes Disease)
Description
Perthes disease typically occurs in children who are between 4 and 10 years old. It is five times more common in boys than in girls, however, it is more likely to cause extensive damage to the bone in girls. In 10% to 15% of all cases, both hips are affected. The cause of Perthes disease is not known.
Symptoms
One of the earliest signs of Perthes is a change in the way your child walks and runs. This is often most apparent during sports activities. Your child may limp especially after running or sports activities. Other common symptoms include:
- Pain in the hip or groin, or in other parts of the leg, such as the thigh or knee (called “referred pain.”).
- Pain that worsens with activity and is relieved with rest.
- Painful muscle spasms that may be caused by irritation around the hip.
Depending upon your child’s activity level, symptoms may come and go over a period of weeks or even months before a doctor visit is considered.
In the first stage of Perthes disease, the bone in the head of the femur slowly dies.
In this X-ray, Perthes disease has progressed to a collapse of the femoral head (arrow). The other side is normal.
Investigations
X-Rays – These scans create pictures of dense structures like bone, and are required to confirm a diagnosis of Perthes. X-rays will show the condition of the bone in the femoral head and help determine the stage of the disease.
A child with Perthes can expect to have multiple X-rays taken during treatment, as the condition progresses, x-rays often look worse before improvement is seen.