top of page

Perthes' Disease

This is where there's ischaemia of femoral head, leading to Avascular Necrosis.


The main complication that can occur here is a soft and deformed femoral head → Early OA.


Presentation

  • Gradual hip pain

  • Limp, worsened with activity

  • Restricted ROM

  • No hx of minor trauma – Differentiates it from SUFE, especially in older children


Investigations

  • XR – May be normal in early stages due to fragmentation and remodelling of proximal femoral epiphysis

  • Bloods – CRP to exclude inflammatory causes of joint pain

X-ray image of Perthes disease - Praxis Dr. Lengerke (https://commons.wikimedia.org/wiki/File:Roe-perthes.jpg)

Management

  • If < 50% of femoral head is involved – Conservative measures like rest, traction and crutches

  • If > 50% of femoral head is involved – Plaster case or surgery

    • This carries a higher risk of OA later in life

  • Physiotherapy



bottom of page