Our 11-year old daughter wants to do gymnastics badly. But when she went to the first couple of classes, it became apparent that she doesn’t have full motion of her right hip. When she was four-years-old, our pediatrician said she had Perthes disease. There wasn’t any special treatment at that time. We just had to take her in every six months for check-ups. Did we miss something?

Perthes disease (also known as Legg-Calve-Perthes) is a condition that can affect the hip in children between the ages of four and eight. In this condition, the blood supply to the capital femoral epiphysis (growth center of the hip) is disturbed. The head of the femur (thigh bone) starts to die. The blood supply eventually comes back, and the bone heals.

But the smooth, round shape of normal femoral head may end up oval-or egg-shaped. This type of deformity can affect the child later in life.
The large end of the egg-shaped bone forms a hump. If the hump is small enough, no changes occur. But if it’s too large, when the child bends or straightens the hip, the hump can bump up against the rim of the acetabulum (hip socket). The bone can’t slide or glide any further because the hump is in the way.

The hump deformity of the femoral head can force the upper part of the femur to adapt to keep motion as normal as possible. Rotating the femur changes the location of the hump in the socket and reduces or eliminates the impingement. But there can be some loss of hip motion in the process, especially hip flexion, abduction (movement away from the body), and extension.

A medical evaluation may be a good idea. Consider taking her back to the orthopedic surgeon who followed her so closely at the start. Using records from that time and comparing them to more up-to-date X-rays and/or CT scans will help determine the cause of the problem. Treatment will be planned according to the results of the tests.