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Perthes’ Disease

I always feel very privileged that people entrust me with their most prized possessions – namely the health of their children! I work with a huge number of children and adolescents, and so I thought I would write a few blogs on a few conditions that are unique to that age group. I will look at hip, knee and heel pain.

First up, hip pain, and more precisely – Perthes’ Disease.

Perthes disease is a childhood disorder which affects the head of the femur – the thigh bone. In Perthes disease the blood supply to the growth plate of the bone at the end of the femur (called the epiphysis) becomes inadequate and as a result the bone softens and breaks down (a process in adulthood called avascular necrosis). The condition typically occurs in children who are between 4 and 12 years old, and it is up to five times more common in boys than in girls. Approx. 1 in 9,000/10,000 children are affected, so it is rare. It usually only affects one hip, but both hips are affected in about 1 in 7 children with Perthes’.

The cause is not entirely clear. It is not due to acute injury, or a vascular problem, and a child with Perthes’ disease is ordinarily fit and well. Some research suggests it that there may be a genetic link, but this is far from conclusive.

Perthes; can be easily misdiagnosed due to rarity and ranging symptoms. One of the earliest signs is a change in your child’s gait – how they walks and/or run, often most apparent during sporting activity. Your child may develop a limp, have limited range of motion, or develop an asymmetrical running style. Other common symptoms to be aware of include:

  • Pain in the hip or groin
  • Pain in the knee (Perthes’ is NOT a knee condition)
  • Pain that worsens with activity and is relieved with rest.
  • Muscle wasting in the thigh of the affected leg.
  • Shortening of the affected leg.
  • Painful muscle spasms

Depending upon the length of time your child has been suffering, and on your child’s activity level, symptoms may come and go over a period of weeks or even months. The long-term prognosis for children with Perthes is good in most cases, although it has been linked with arthritis in later life.

As always, if in doubt, get it checked out.

N.B. There are no ‘one size fits all’ style quick fixes in most injury scenarios, so these article shouldnt be seen as such. They are merely guides to a better understanding of how our bodies work.

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