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Perthes Disease

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Perthes Disease


Perthes disease (also called Legg-Calve-Perthes disease) is a condition where there is damage to the hip joint due to lack of blood supply to the femoral head in children (ball of the hip joint). Damage due to a lack of blood supply causes death of the bone. The cause of Perthes disease remains unknown. Perthes disease is more accurately called “Idiopathic avascular necrosis of the femoral head” in a child (Idiopathic: Having no known cause).

Causes of Calve Perthes Disease Perthes disease affects the top of the femur (thigh bone) where it meets the hip bone. The blood supply to the growth plate of the bone (epiphysis) becomes inadequate. As a result, the bone softens and breaks down - a process called necrosis.

This happens gradually over several weeks. Then, as the blood supply recovers, the bone reforms and hardens. This takes 18 to 36 months and may lead to a deformed shape, with flattening of the ball-shaped head of the femur that normally fits into the round socket of the hip joint. Recent research has suggested Perthes' may be linked to a subtle problem with blood clotting.

What are the symptoms?

  • The first sign of Perthes' hip disease is usually hip or groin pain, or a limp. Knee pain can also be an early symptom.
  • The pain persists and there may be wasting of the muscles in the upper thigh, shortening of the leg and stiffness of the hip, which can restrict movement and cause problems with walking.
  • When Perthes' disease has been present for a long time, the affected leg may be shorter and thinner than the unaffected one.

Who's affected?

Perthes' is a hip disorder which most commonly affects children between the ages of four and eight, but younger children and teenagers can also develop the condition. It affects around one in 20,000 children and is up to five times more common in boys. It's also more common among Caucasians. In ten to 20 percent of cases, both hips are affected.

Authored By : DR. DAVID V RAJAN

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