Perthes' Disease

Question 1

What is Perthes’ disease and what does it cause?

Answer 1

1. Lack of blood supply to the epiphysis of the femoral head.
2. Avascular necrosis - loss of bone mass and deformity of the femoral head.

Question 2

What is this a presentation of?
4-10 years, boys. Unilateral, gradual painless limp or mild/intermittent hip or referred knee pain over a few weeks. Reduced abduction and internal rotation. Quadriceps wasting, fixed flexion deformity.

Answer 2

Perthes’ disease

Question 3

How is Perthes’ disease diagnosed?

Answer 3

X-ray shows flattened femoral head with increased bone density and joint space widening.

Question 4

What is the management of Perthes’ disease?

Answer 4

Surgery may be needed to keep femoral head in the acetabulum.