Child health information factsheet
Perthes disease
There is loss of blood supply to the femoral head (bone in the hip) causing the bone to become
soft and collapse. Eventually the blood supply returns and the femoral head heals usually within
two years. This may result in deformity of the femoral head causing hip problems
It is a common hip disorder in children but there is little understanding about why it happens.
Perthes disease affects boys more than girls usually aged between three to 12 years old with the majority
being aged five to seven years old.
Symptoms
Some children have an acute onset of pain and hip irritation, or may have pain to the knee referred from
the hip. They may have had the pain for a few weeks.
They may walk with a limp and may have not have full movement of their leg.
Testing for perthes disease
X-rays are taken to confirm the diagnosis and blood tests are done to check there is not an infection.
A bone scan may be considered to help with the diagnosis. A separate leaflet is available on this.
Treatment
Perthes disease varies in it’s severity and this dictates the treatment your child will recieve. The overall aim
is to keep the head of the femur (leg bone) well positioned in the hip socket. This encourages the blood
supply to return and promotes growth at the hip joint.
Treatment A: If the hip is in a good position and there is no spasm, your child will be seen regularly in
the outpatient clinic. An x-ray will be taken at each visit to monitor the progress.
If the head of the femur is healing, then your child will continue to be followed up in the outpatient
clinic until it is completely better.
If your child has pain in the hip, then your child will start on treatment B.
Treatment B: if the hip is in a good position and your child has pain or spasm, he or she will be
admitted to hospital for simple traction.
This means being on bed rest, sometimes for up to seven to fourteen days. The traction is applied with
bandages, and weights are attached to the end which helps to reduce pain by resting the hip joint.
Regular pain relief will be given and your child may have hydrotherapy (therapy in water) to encourage
easy movement of the hip joint.
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Child health information factsheet
When the pain and spasm has settled, your child will be able to go home and will be followed up
regularly in the outpatient clinic.
Treatment C: if the head of the femur is not well placed in the hip joint, or there is loss of function of
the joint and there is pain or spasm, your child will be admitted to hospital for a period of skin traction to
overcome spasm. (see treatment B).
Surgery may be considered to improve the position or function of the hip joint. Separate information
booklets are available about each operation. These include:
• Soft tissue release: an operation to improve movement in the affected hip by releasing certain tight
muscles in the groin.
• Shelf acetabuloplasty: an operation to make the pelvic cup (acetabulum) larger
• Pelvic osteotomy: an operation to alter the position of the socket
• Femoral osteotomy: an operation to alter the position of the femoral head within the socket.
Your consultant will discuss the best option with you.
Ongoing care
Your child will have regular appointments in the outpatient until they are better.
It is a good idea to discuss your child’s needs with their school.
If you have any questions or concerns please contact
Julia Judd and Liz Wright Advanced nurse practitioners: 023 8079 4991
Switchboard: 023 8077 7222 bleep 2641
Ward G3: 023 8079 6486
Your GP
If you need a translation of this document,
an interpreter or a version in large print,
Braille or on audio tape, please telephone
023 8079 4688 for help.
V4 Revised Sept 2011 Review date Sept 2014 CHO.013.04
www.uhs.nhs.uk