Perthes Disease, also known as Legg-Calve-Perthes disease is a childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.
This weakened bone gradually breaks apart and can lose its round shape. The body eventually restores blood supply to the ball, and the ball heals. But if the ball is no longer round after it heals, it can cause pain and stiffness. The complete process of bone death, fracture and renewal can take several years. Also Read: Recovering After A Bone Fracture? Here’s What You Should Eat
Legg-Calve-Perthes disease occurs when too little blood is supplied to the ball portion of the hip joint (femoral head). Without an adequate blood supply, this bone becomes unstable. Hence, the hip bone in children may break easily, undergo fractures and heal poorly. The underlying cause of the temporary reduction in blood flow to the femoral head is still unknown.
Although Legg-Calve-Perthes disease can affect children of nearly any age, it most commonly begins in childhood, between ages 4 and 8. Also Read: 5 Effective Ways To Build Your Child’s Bone Health
Legg-Calve-Perthes is up to five times more common in boys than in girls.
In a small number of cases, Legg-Calve-Perthes disease appears to be linked to mutations in certain genes.
Signs and symptoms of Legg-Calve-Perthes disease include:
Limited range of motion of the hip joint
Diagnosis And Treatment
During the physical exam, the doctor may move the child's legs into various positions to check range of motion and see if any of the positions cause pain. In addition, imaging scans like X-rays and MRI tests are also conducted, to view the exact location of deterioration to the hip bones.
Treatment for Perthes disease depends on the age of the child as well as the extent of hip damage.
As Legg-Calve-Perthes disease progresses, the ball part of the joint (femoral head) weakens and fragments. During healing, the socket part of the joint can serve as a mould to help the fragmented femoral head retain its round shape.
For this moulding to work, the femoral head must sit very snugly within the socket. Sometimes this can be accomplished with a special type of leg cast that keeps the legs spread widely apart for four to six weeks.
Some children require hip surgery, like in hip dysplasia, to help keep the ball of the joint snug within the socket. This procedure may involve making wedge-shaped cuts in the thighbone or pelvis to realign the joint.
Surgery usually isn't needed for children younger than 6. In this age group, the hip socket is naturally more moldable, so the ball and socket typically continue to fit together well without surgery.