Does Perthes disease cause limping?

Perthes disease affects the blood supply and development of the ball at the top of the thigh bone in a child’s hip. Hip discomfort can be felt in the groin, thigh, or knee, so the child may not point to the hip. To reduce discomfort, they may shorten their stride, avoid putting full weight through one leg, or walk with the leg turned outward.

The limp may be more noticeable after activity and may improve with rest. A child can have a limp without obvious pain, which is why a new or persistent change in walking deserves assessment rather than being dismissed as a habit.

Arrange an appointment with a doctor if a child develops a limp that does not quickly settle, especially when hip, thigh, or knee discomfort is present. Until assessed, reduce impact activities such as running and jumping if they worsen symptoms. Do not force painful hip stretches or encourage the child to keep playing through a worsening limp. Keep notes about when the limp appears and any changes in movement.

Seek urgent medical care if the child suddenly cannot bear weight, has severe hip or leg pain, develops fever, or appears acutely unwell. Prompt assessment is also needed after an injury, or when the hip becomes markedly stiff, swollen, or difficult to move. These features can have causes other than Perthes disease and should not wait for routine review.

Ask whether the walking pattern and hip movement suggest Perthes disease, whether imaging is needed, and which activities are safe while waiting. Ask how to monitor hip motion, what symptoms should trigger earlier review, and whether physiotherapy or an orthopaedic referral is appropriate.