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Perthes Disease, Pediatric

Harry K.W. Kim, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Childhood femoral head osteonecrosis of unknown etiology, which can weaken the femoral head and produce a permanent deformity in some patients, predisposing them to early arthritis 

EPIDEMIOLOGY

DIAGNOSIS

HISTORY

  • Age at onset of symptoms, duration, patient’s activity level, and risk factors for osteonecrosis are important.

  • Age at onset before 6 years has better prognosis than after 6 years.

  • Most...

TREATMENT

  • Treatment principles:

    • Restore and maintain good hip motion, especially abduction.

    • Prevent collapse and lateral extrusion of the femoral epiphysis.

  • Initial treatment for symptomatic patients inc...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patient should be seen every 3 to 4 months to assess disease progression and compliance to treatment during the active phase of disease.

  • Activity and weight-bearin...

ADDITIONAL READING

  • Frick SL. Evaluation of the child who has hip pain. Orthop Clin North Am.  2006;37(2):133–140. [View Abstract on OvidInsights]

  • Kim HK. Legg-Calvé-Perthes disease. J Am Acad Orth...

CODES

ICD9

732.1 Juvenile osteochondrosis of hip and pelvis 

ICD10

  • M91.10 Juvenile osteochondrosis of head of femur, unspecified leg

  • M91.11 Juvenile osteochondrosis of head of femur, right leg

  • M91.12 Juven...

FAQ

  • Q: When should I get radiographs?

  • A: Diagnosis of Perthes requires radiographic confirmation. AP pelvis and frog-leg lateral radiographs should be obtained when a child presents with intermittent t...

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