Perthes Disease Explained | Hip Disorder in Children | Symptoms, Causes & Treatment – By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals

Perthes Disease Explained | Hip Disorder in Children | Symptoms, Causes & Treatment – By Dr. Balaraju Naidu, Robotic Orthopedic Surgeon, ONUS Robotic Hospitals

Introduction

Perthes Disease, medically known as Legg-Calvé-Perthes Disease, is a childhood hip disorder that occurs when the blood supply to the femoral head (ball of the hip joint) is temporarily reduced.

Without adequate blood flow, the bone weakens, collapses, and gradually reshapes during healing. If not diagnosed early, it can lead to permanent hip deformity and early arthritis in adulthood.

Perthes Disease most commonly affects children between 4 to 10 years of age, especially boys.

Early diagnosis is the key to preserving hip function.

What Happens in Perthes Disease?

The condition progresses through stages:

1. Loss of blood supply to femoral head

2. Bone weakening and collapse

3. Gradual healing and reshaping

4. Possible deformity if untreated

The goal of treatment is to maintain the round shape of the hip joint during healing.

Causes of Perthes Disease

The exact cause remains unclear, but possible contributing factors include:

• Temporary interruption of blood supply to hip bone

• Genetic predisposition

• Repeated minor trauma

• Growth disturbances

• Environmental and developmental influences

In most cases, the condition is not preventable — but early detection greatly improves outcomes.

Symptoms of Perthes Disease

Parents should look for:

• Limping without significant injury

• Hip, groin, thigh, or knee pain

• Limited hip movement

• Stiffness after activity

• Difficulty running or playing

• Reduced range of motion

⚠️ Important: Some children complain only of knee pain, which can delay correct diagnosis.

Persistent limping should never be ignored.

How Is Perthes Disease Diagnosed?

Diagnosis includes:

• Detailed physical examination

• X-rays of the hip joint

• MRI in early or doubtful cases

MRI can detect early changes before X-rays show abnormalities.

Early imaging helps guide the most appropriate treatment plan.

Treatment Options

Treatment depends on:

• Child’s age

• Stage of disease

• Severity of bone collapse

• Hip joint range of motion

Non-Surgical Treatment (Common in Younger Children)

✔ Activity restriction
✔ Physiotherapy
✔ Anti-inflammatory medications
✔ Monitoring with periodic X-rays

Bracing or Casting

Used in selected cases to keep the femoral head well positioned in the socket.

Surgical Treatment

Recommended in severe deformity or in older children to:

• Improve hip alignment

• Maintain round femoral head

• Prevent early arthritis

Long-Term Outlook

Children diagnosed early and treated appropriately often regain good hip function.

Delayed treatment may lead to:

• Permanent hip deformity

• Chronic pain

• Early osteoarthritis

• Need for hip replacement in adulthood

Final Message

Persistent limping or unexplained hip/knee pain in children should never be dismissed as “growing pain.”

Early orthopedic consultation ensures better hip development and prevents long-term complications.

Healthy childhood hips mean healthier adulthood mobility.

For Appointments:

Dr. Balaraju Naidu, Robotic Orthopedic Surgeon

ONUS Robotic Hospitals – Hyderabad

👉 Button link: contact-us or book-appointment