Brad (7)

[tracey]

My son Brad was diagnosed with Perthes in late January. We don't go back for more X-Rays until mid-march, when they say they will be able to tell us more about his condition. His limp is about the same as it's always been and he's not in much pain - really he hasn't curtailed his activities at all except we are out of organized sports for now.

So far, the Perthes doesn't really seem to be affecting his life, but from the posts I've seen on here it seems like almost everyone has to have surgery or at least casts or traction. What are the chances that he will get better on his own? Are we just too early in his condition for it to be causing him much pain? Any thoughts would be appreciated.

[Donna Brown]

Hi

Statistically 80% of children diagnosed with perthes will need no intervention at all. The other 20% is heavily represented by the older diagnosis kids (8 years plus), as time isn't on their side and so intervention (surgery usually) sets the body up in such a way that it can get on with healing and repairing the damage.

The reason that you will see more of the surgical intervention kids represented online, is because their parents are the ones that are most likely to go looking for answers to their questions and alternative approaches to this. For the kids that don't need intervention, life does tend to just go on, with some restrictions needed, some pain relief as needed and maybe getting them swimming, to ensure the best outcome.

The reason why restrictions are put in place is because activity - particularly the impacting ones - cause inflammation and inflammation equals pain, so to restrict their activities should in theory reduce the pain they experience. But for some kids, there is no real relief from it and for others, pain just isn't a real problem. Each case of perthes is as unique as the child themselves is.

For the most part perthes is self-limiting and most kids will stop doing what they are doing, if it hurts. HOWEVER, get any child engrossed in an activity, particularly with their friends or siblings and watch them push through that barrier without thinking about it!

Its probably a great a idea that Brad isn't doing organised sport for the time being and depending on his age, what his ROM is like and whether or not his femoral heads remain contained, no other changes may be needed, but even a specialist can't really tell you what the future holds and perthes does have a tendency to do its own thing, regardless of what we wish to happen.

Donna

[tracey]

Thanks for the info. I'm sure you are right - children who are less affected by the Perthes are probably not as likely to post on the message boards. We are just thankful that he's not in pain for now and taking it day by day.