Many people who have Perthes disease during childhood developearly hip arthritis, often requiring hip replacement in adulthood.
Treatment is best determined by the stage of disease and age at which the condition is diagnosed.
Treatment remains controversial, sometimes requiring surgery in the childhood years, other times being managed with nonsurgical treatments.
Verywell/JR Bee
Research is ongoing to determine the causes, prognostic factors, and ideal treatment of Perthes disease.
Symptoms
Perthes disease tends to occur in children between the ages of 4 and 10 years old.
It can occur during a broader range of ages, but it most commonly emerges in those childhood years.
One specific test that your healthcare provider will look for is a so-called “Trendelenburg sign.”
Children who develop Perthes disease have a problem with the bone and cartilage of the ball-and-socket hip joint.
Over time, there is deterioration and deformity of the femoral head, the ball of the joint.
Some other conditions that can mimic the signs of the disease includesickle cell diseaseandcorticosteroid treatment.
The severity of the condition depends on the extent of damage to the blood supply of the femoral head.
There is no blood test that will diagnose Perthes disease.
X-raysare typically obtained to assess the degree of damage to the bone of the hip joint.
These X-rays are used to classify the extent of the Perthes disease.
Treatment
In general, there are three options for treatment of children with Perthes disease.
The second option is to use a brace to immobilize the hip joint.
Treatment of Perthes disease is guided best by the age of onset of symptoms.
Children less than 6 years of age seem to do best with nonsurgical treatments.
Children over the age of 8 years old tend to have better results with surgical intervention.
Even with surgical intervention, children who have Perthes disease often develop permanent damage to the hip joint.
This is generally well-tolerated in the teenage and young adult years.
Young adults who had Perthes as a child will typically resume all normal activity without hip problems.
As these individuals age, most will develop arthritis in their 50s, often requiringhip replacement surgery.
The cause of Perthes disease is not clear, and the ideal treatment remains controversial.
A hip replacement surgery is often necessary for these people.
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