Perthes' disease is a type of joint-bone disease that usually occurs in childhood and is most common in boys. This disease occurs in children, causing difficulties such as limping and limping in walking. In Perthes disease, early diagnosis is of great importance to prevent the disease from developing, and the disease should be followed from childhood to adulthood.
Perthes' disease, which usually occurs in childhood, is an orthopedic disease in which the course of treatment is important. In Perthes' disease, where bones and joints are targeted, it is important to follow the disease throughout life. Perthes' disease manifests itself with symptoms such as the child limping or limping while walking due to a pathological problem in the hip. Early diagnosis and diagnosis of this disease, which is more common in boys than in girls, is important to prevent the disease from progressing and causing more serious problems in the future, but it is also important for healthy growth and development. Perthes' disease, which has become widespread in recent years, is frequently seen in children between the ages of 10 and 12, and this disease has an important place among the painful diseases that occur in childhood.
Perthes' disease usually affects only one thigh. However, in some cases, the disease has been seen to develop in both thighs. This may cause perthes disease, which normally affects a single thigh, to be confused with different diseases.
What Causes Perthes Disease?
Perthes disease, which may take years to heal, is often referred to a physician with the complaint of difficulty in walking. It occurs when the nutrition of the thigh bone (femur) in the hip deteriorates and loses its strength. In Perthes' disease, which targets the femur, the body tries to repair the damaged femoral head, while the bone in the repair process is still weak and flimsy, making it difficult to perform movements during daily activities and may break. In this case, the femoral head collapses and deforms with the fracture. The ossification nucleus at the head of the thigh allows the bone to grow, and due to the lack of blood supply to this area, the growth stops. This leads to shortening of the leg and the person develops Perthes' disease.
Especially in 10% of children, the second hip is also affected.
What are the Symptoms of Perthes Disease?
Perthes' disease is a disease with mild symptoms in the beginning. Sometimes it is asymptomatic, and sometimes it may come to the fore with mild hip and knee pain. For this reason, it is not taken seriously by children and families and is thought to be temporary. Common symptoms of this disease can be listed as follows:
- Pain in the hip and knee
- Limping and gait disturbance
- Thinning of the leg diameter and stunted development of the leg
- Swelling in the legs
- Shortening of the leg
- Difficulty in joint movements
The above are common symptoms of Perthes' disease, but they will vary according to the person and the circumstances. Symptoms that are mild at the onset of the disease may worsen or become milder from time to time.
Since early diagnosis is of great importance in Perthes disease, it is important that children with pain in the hip and knee area are examined by an orthopedic specialist as soon as possible.
How is Perthes Disease Diagnosed?
To answer the question of how Perthes disease is diagnosed, the process of diagnosing the disease begins with a patient history taken by a specialist orthopedic doctor together with a physical examination. Radiographic findings are important in this process. In the early stages of the disease, MRI (magnetic resonance imaging) examinations are functional in making the diagnosis. MRI and tomography examinations can be used if the radiological findings show a normal picture and if the pain and disruptions in the body do not disappear within 10 days. If perthes disease is diagnosed after these examinations, the treatment process should be started as soon as possible and the process should be managed meticulously.
Stages of Perthes Disease
There are 4 stages of Perthes' disease that can occur.
Stage 1: (H3) This is when the disease first manifests itself. In this stage, the patient may not show any symptoms. It is only possible to diagnose the disease through radiological images.
Stage 2: (H3) Early symptoms of the disease may occur during this stage. Patients usually consult a doctor at this stage.
Stage 3: (H3) The disease shows its symptoms more clearly. Towards the end of this stage, bone tissue damage is clearly visible at the head of the femur.
Stage 4: (H3) In the last stage of the disease, if the disease progresses and is left untreated, permanent damage to the hip joint can occur. If osteoarthritis is severe, the patient may need to have an artificial hip joint surgically implanted at an early age. The main aim of the treatment is to help the body regenerate bone tissue and ensure that the femoral head remains in its socket in the hip joint.
What are the treatment methods for Perthes' disease?
In the treatment of Perthes' disease, bone necrosis, or necrosis, is sometimes seen in some or all of the femur due to the lack of nutrition and damage to the femur. The body removes this damaged bone and reconstructs the bone. During reconstruction, the femoral head takes shape according to the mold it is in. Therefore, the aim of the treatment is to keep the hip joint in the socket.
The main goal in the treatment of the disease is to preserve the range of motion of the joint. This is important for the head to develop fully. Anti-inflammatory drugs and rest contribute to the healing process. The treatment process for Perthes' disease takes about 2 years. During this time, it is not advisable for the patient to engage in sports activities, jumping or hopping, or movements that overwork the hips and should be avoided. Otherwise, carrying out daily activities is not a problem. Since the course of the disease lasts for more than 2 years, it is difficult for children to adapt to plaster and orthotic treatments. For this reason, orthopedic physicians usually refer the patient for surgical intervention.
However, the application of plaster casts to keep the femoral head ball in the socket, the use of orthoses and surgical interventions can be explained as other alternative methods used by orthopedic specialists.