Perthes disease

Perthes disease, osteochondropathy femoral head - a disease associated with circulatory disturbance and destruction of the femoral head. The disease is prolonged and 20-25% of the children produced severe deformity of the femoral head and subsequently developed a deforming coxarthrosis. Treatment methods of conventional medicine is to improve the blood supply, ensuring the rest of the affected area of bone.

If you violate the blood supply of bone of the femoral head, resulting in partial necrosis (necrosis) of bone tissue. This process is accompanied by pain and lameness, but X-rays at this point can not be any changes.

In what areas of necrotic bone exposed to resorption. This changes the shape of the femoral head - of the globe, it turns into a mushroom, flattened. Next, the femoral head sclerosis, the process of necrosis was already over and the bone is no longer sick. Despite this, the pain still remains, as now begins to break down joint cartilage - is developing arthrosis. What has changed form the femoral head, the more pronounced arthrosis develops, the more pain and limp.

The process is more often unilateral, at least - two-sided. The initial stages are asymptomatic. The first symptoms - a slight soreness in the hip joint and lameness, sometimes the disease begins with pain in the knee joint.

Later manifest fatigue while walking, joint pain, lameness, atrophy of the gluteal muscles, restriction of rotational motions and abduction of the hip, shortening of the limbs.

X-ray examination. Depending on the disease stage femoral head may be smaller, flattened shape and osteoporotic, fragmented or sclerosal structure.

At later stages the head takes mushroom shape. The cervix is shortened, reduced neck-diaphyseal angle. Articular cavity expanded. Radioisotope scanning with 99mTc identifies areas of impaired circulation. MRI reveals necrosis or early stages.

The earliest symptoms of Perthes' disease are pain and lameness. However, it should be borne in mind that a certain group of patients with pain may be absent. Lameness at the beginning of the disease may result from pain and joint contractures, and later - a consequence of the weakness of the gluteal muscles, subluxation of the hip. Muscle atrophy also relates to an early and constant symptom of the disease. The main clinical symptoms of Perthes' disease expressed more pronounced than in older age it occurs. A special place in the manifestation of Perthes' disease belongs to vegetative-vascular disorders, which are more pronounced when one-sided defeat. Clinically, they appear pale feet, its cooling and increased sweating, decreased heart rate in the area of fingers, wrinkled skin of the foot plantar surface ("skin washerwoman"). Very rarely Perthes disease begins acutely, there are an expression of pain in the hip joint, the temperature rise, "inflammatory" changes the blood.