Perthes disease refers to pathologies of bones and joints and is characterized by the destruction of the femur, and potentially the entire hip joint. The disease occurs in childhood, and it happens in children not so rarely, but parents, unfortunately, in most cases are not even aware of such an ailment. Perthes disease in children, the symptoms of which are not detected in the first stages of the course, is diagnosed already when changes have occurred in the hip joint. Children under the age of five rarely suffer from this disease, it is more typical for children aged six to ten years, more often than boys.
Why does a child develop Perthes disease
It is still not possible to fully establish the causes of the disease. It is believed that the bone is destroyed as a result of deterioration in the blood circulation in the joint, which happens due to injuries, metabolic disorders, past infections, abnormalities in the development of blood vessels, and others.reasons.
How Perthes disease manifests in a child
As already mentioned, at the initial stages, the signs of pathology are almost not expressed. Over time, a slight lameness appears, it may disappear after rest, and then reappear. Often children complain of pain not in the hip, but in the knee joint, since pain radiates to the knee. Such pains can appear during the day when walking. As Perthes disease progresses in a child, one can notice a slight decrease in the soft tissues of the lower leg and thigh in volume, limitation of extension and rotation of the hip joint. Usually such signs are not given due attention, or they go unnoticed at all, because the general condition does not change.
Stages of disease
A child develops Perthes disease slowly. At the first stage - the stage of subcartilaginous necrosis - the head of the femur begins to flatten. The second stage - the stage of an impression fracture - is manifested by compaction with an even greater flattening of the femur. At the third stage - the stage of formation of bone fragments - the bone may stop growing, the development of subluxation (exit of the bone from the joint cavity) is possible. The fourth stage is the stage of restoration of the structure, and the fifth stage is the stage of consequences. Despite the fact that the structure of the femur is completely restored, the shape of its head most often remains deformed, which leads to lifelong irreversible dysfunction of the joint. You can clearly see on x-raysPerthes disease in any of its stages, however, due to the fact that the characteristic symptoms of the disease are absent, x-rays in most cases are carried out very late.
Perthes disease in children: treatment
Conservative or surgical treatment may be applied. In the first case, the affected limb is unloaded by assigning the child to bed rest and then walking on crutches. Along with this, general strengthening therapy is performed, which consists in taking vitamins, performing physiotherapy procedures, massage, and therapeutic exercises. Only when the structure of the femoral head is completely restored, you can start walking with full weight on the leg. Surgical treatment is aimed at stimulating the restoration of blood circulation in the joint.
