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.
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