Perthes disease

Question 1

What is it?

Answer 1

a degenerative condition affecting the hip joints of children, typically between the ages of 4-8 years.

It is due to avascular necrosis of the femoral head, specifically the femoral epiphysis.

Impaired blood supply to the femoral head causes bone infarction.

Question 2

ages

Answer 2

4-8 years

Question 3

males or females

Answer 3

males

Question 4

features

Answer 4

hip pain: develops progressively over a few weeks
limp

stiffness and reduced range of hip movement

Question 5

Ix

Answer 5

Xray

technetium bone scan or magnetic resonance imaging if normal x-ray and symptoms persist

Question 6

what is seen on XR

Answer 6

early changes include widening of joint space,

later changes include decreased femoral head size/flattening

Question 7

complications

Answer 7

osteoarthritis

premature fusion of the growth plates

Question 8

staging system

Answer 8

Caterall

Question 9

Mx

Answer 9

To keep the femoral head within the acetabulum: cast, braces
If less than 6 years: observation
Older: surgical management with moderate results
Operate on severe deformities

Question 10

prognosis

Answer 10

Most cases will resolve with conservative management. Early diagnosis improves outcomes.