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Perthes Disease

Perthes' disease is a painful disorder of childhood in which the blood supply to the head of the thighbone (femoral head) is reduced. This causes the femoral head (the ‘ball’ in the ‘ball and socket’ joint of the hip) to soften and break down; a process known as ‘avascular necrosis’. The underlying cause for this reduction in blood supply is currently unknown.   

It is not a common disorder and only affects about one in 10,000 children. It tends to affect children between the ages of four and eight years, although rarely it has occurred in children as young as two and as old as 12 years.  Boys are more likely to be affected than girls.   

The main way to diagnose Perthes’ disease is to x-ray the hips. This is done at regular intervals to look for any changes in the hip joint and the shape of the head of the femur. 

Children with Perthes' disease tend to complain of pain in their hip, which is worse during movement and causes them to limp. They usually become less active because of this. In 90% of cases the disorder will only affect one hip, although it can affect both. Symptoms can continue for weeks at a time, or they may recur now and then.  

Orthopaedic staff help to relieve the symptoms of the disease when the hip is painful or irritable, which usually lasts about three weeks.  We encourage patients to rest the hip and take gentle exercise, give pain relief and hold regular reassessments.

The hip joint often recovers over time and children may just have to attend regular check-up appointments over two or three years. However, in some cases an operation is required to position the head of the thighbone correctly within the hip joint.   

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