2 November 2011 (Wednesday) - Perthes Disease
This disease attacks the femoral head (the ball part of the ball-and-socket hip joint). Starting in children aged 4 to 8, it occurs in boys four times as often as girls. Those who are small for their age are also at risk.
LCP typically affects only one hip in which the femoral head gradually weakens and dies from a lack of blood supply. It becomes brittle and may collapse, leading to deformity and arthritis. The problem develops gradually. The child will begin to feel pain in the hip joint or knee, and then start to limp. The limp may get worse with activity. The affected leg may be shorter than the other.
The causes are still rather uncertain, heredity, trauma, endocrine, inflammatory, nutritional, and altered circulatory haemodynamics have all been cited.
X-rays and MRI may be helpful in confirming the diagnosis. The goal of treatment is to avoid severe degenerative arthritis. Perthes disease is self limiting, but if the head of femur is left deformed there can be a long-term problem. Treatment is aimed at minimizing damage while the disease runs its course, not at 'curing' the disease. However the child may need traction followed by bracing, or may require an osteotomy to shift weight away from the collapsing bone.
Labels: case study