Mark O'Sullivan

Hip

PERTHES DISEASE


Perthes disease is a complex hip condition that affects children most commonly between 5 and 10 years of age. Both boys and girls can develop Perthes disease. We have seen the disease present anywhere from 3 to 14. It is a fairly common condition in our community and it is a disease of unknown cause. Many international studies have been undertaken without resolving this question.

Children present with a limp and reduced range of motion. X-rays can be normal initially but change over the first 3 months. If the X-rays are normal, sometimes MRI or Bone Scan are used to help make the diagnosis.

The initial management is non operative, trying to reduce the pain and increase the range of hip movement. Treatment is tailored to your child.

Treatment depends on the stage of the disease, the range of hip movement and the age of the child. The younger the child (particularly under 5), the less likely advanced treatment is needed.

Treatment includes:

1. Reducing the irritability of the joint with reduced activity, crutches, bed rest, Non-steroidal anti-inflammatory medication, slings and springs and plasters

2. If conservative treatment is failing then we consider and discuss the role of surgery, usually with pelvic or femoral osteotomies