What is Perthes’ Disease?
Perthes disease, also known as Legg–Calvé–Perthes disease, is a childhood condition that affects the hip joint. It occurs when the blood supply to the head of the thigh bone (femoral head) is temporarily reduced. Without enough blood, the bone becomes weak and can lose its round shape inside the hip socket.
Perthes disease usually develops slowly over several months. In most cases, the bone gradually heals as new blood vessels grow and the hip reshapes with proper care and activity management.
What Happens in Perthes Disease?
The femoral head, which is the ball part of the hip joint, relies on a steady blood supply to stay healthy. When that supply is interrupted, the bone cells begin to die (avascular necrosis). Over time, the bone becomes softer and may flatten or lose its smooth shape.
As healing occurs, new bone grows to replace the damaged area. With correct management, the hip can return to a healthy shape, though this process may take several years.
Common Causes and Risk Factors
- More common in children aged 4–10 years
- More frequent in boys than girls
- Family history of childhood hip disorders
- Exposure to second-hand smoke or poor circulation
- Low birth weight or delayed growth patterns
Who is Most Affected?
- Children aged 4–10 years
- Active children who play sports or run often
- Boys (approximately 4:1 ratio compared to girls)
- Children with a family history of hip problems
Symptoms of Perthes Disease
- Limping without obvious pain at first
- Pain in the hip, thigh, or knee that worsens with activity
- Stiffness or reduced hip movement
- One leg appearing slightly shorter than the other
- Muscle wasting around the thigh due to reduced use
📞 If your child has a limp or persistent leg pain, book an assessment at Spinal and Sports Care Bella Vista or Parramatta.
Diagnosis of Perthes Disease
Clinical Assessment
A clinician will examine your child’s hip and walking pattern, testing range of motion, strength, and any signs of stiffness or guarding.
Imaging
- X-ray: confirms changes in the femoral head shape and stage of healing
- MRI: detects early bone changes before they appear on X-ray
- Ultrasound: may help detect joint fluid or inflammation
📞 Spinal and Sports Care can arrange imaging referrals and provide reports to your child’s GP or specialist.
Treatment Options
Treatment aims to protect the hip, relieve pain, and allow the bone to heal in the best possible position.
Non-Surgical Management
- Physiotherapy: gentle stretching and strengthening to maintain joint movement
- Chiropractic care: gentle mobilisation to support balanced hip motion and comfort
- Activity modification: avoid running and jumping during active stages
- Pain management: heat, rest, or anti-inflammatory medication if prescribed
- Walking aids or crutches in some cases to reduce pressure on the hip
Surgical Management
Surgery is occasionally needed if the hip loses its round shape or becomes unstable. Procedures aim to reposition the hip joint for better healing and long-term function.
📞 Spinal and Sports Care works closely with paediatric orthopaedic surgeons and provides prehabilitation and post-surgical rehabilitation support.
Role of Physiotherapy and Chiropractic Care
- Maintain hip flexibility and movement
- Reduce pain and stiffness
- Strengthen core and lower limb muscles
- Support balance and safe movement patterns
- Guide gradual return to play once the bone has healed
Recovery Timeline
- Early phase: 3–6 months, during which pain and limp are most noticeable
- Healing phase: 1–2 years as the bone reshapes and strengthens
- Full recovery: often achieved within 2–4 years depending on age and severity
Prevention and Family Support
There is no known way to prevent Perthes disease, but early detection and careful management can make a big difference. Parents play a key role by ensuring children stay active within safe limits and follow their exercise plans.
📞 Our team at Spinal and Sports Care provides family-focused care to support both the child and parents through each stage of recovery.
