Perthes Disease

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Definition

-  Ischaemia to head of femur

 

Features

-  Typically presents aged 5-10yrs

-  Male 4:1 female

-  Idiopathic

-  Incidence 1:2000

-  Bilateral <10%

-  Classified as Herrin A, B or C

-  1/3 progress to normal

-  1/3 develop radiological OA

-  1/3 develop clinical OA

-  50% at 40yrs require hip replacement

 

Assocaited S/S

-  Limp

-  Limited abduction

-  Positive Trendelenberg

 

Ix

-  X-Ray

-  Subchondral fracture

-  Sclerosis, resorption, reossification

-  Fragmentation

 

Mx

-  <6yrs bone age: nil

-  6-10yrs

-  Herring A: nil

-  Herring B or C: containment

-  >10yrs: nil

-  Pelvic or femoral osteotomy