Perthes disease Flashcards
(7 cards)
1
Q
What is Perthes disease?
A
- full name is Legg-Calve-Perthes dissease
- disruption of blood flow to the femoral head, causing avascular necrosis of the bone
- this affects the epiphysis of the femur (the bone distal to the growth plate (physis))
2
Q
What age group does Perthes disease affect?
A
Children aged 4-12 years, mostly between 5-8 years. It is more common in boys.
3
Q
What are the causes of Perthes disease?
A
It is described as idiopathic, so there’s no clear cause or trigger for the avascular necrosis. One theory suggests that repeated mechanical stress to the epiphysis may interrupt the blood supply.
4
Q
What happens over time with Perthes disease?
A
Over time, there’s revascularisation or neovascularisation and healing of the femoral head. There is remodelling of the bone as it heals.
5
Q
What are the main complications of Perthes disease?
A
- soft and deformed femoral head, leading to early hip osteoarthritis
- leads to an artificial total hip replacement
6
Q
What investigations are used for Perthes disease?
A
- xray (but can be normal)
- blood tests: usually normal, particularly inflammatory markers that are used to excluse other cause
- technetium bone scan
- MRI scan
7
Q
What is the management for Perthes disease?
A
- severity of perthes varies between patients
- if presenting under the age of 6, there’s a good prognosis and only observation is needed
- initial management in younger and less severe disease is conservative
- aim of management is to maintain a healthy position and alignment of the joint and reduce the risk of damage or deformity to the femoral head. this is with:
- bed rest
- traction
- crutches
- analgesia
- physiotherapy to retain the range of movement in the muscles and joints without putting excess strain on the bone
- regular xrays used to assess healing
- surgery in severe cases, older children or those that aren’t healing (aim is to improve the alignment and function of the femoral head and hip
