Is Perthes disease safe in children?

Perthes disease affects the growing part of the hip joint. Reduced blood supply can temporarily affect the top of the thighbone, and the bone may change while it heals. A child may limp, have hip or groin pain, or report pain in the thigh or knee. Some children have symptoms mainly after activity.

Care aims to preserve hip movement, reduce stress on the joint and support a useful hip shape as the child grows. The plan depends on age, symptoms, movement, imaging findings and how the hip changes over time. Activity restrictions are not a sign that the child must avoid all movement; they help keep force within a safer range.

Attend scheduled orthopaedic reviews and follow guidance about walking, school activity, sport and physiotherapy. Encourage low-impact movement that has been approved, and help the child avoid running, jumping or contact activity when advised. Tell the team about increasing limp, night pain, reduced hip movement or difficulty keeping up with ordinary activities.

Use prescribed medicines only as directed, and ask the clinician how to handle school days, travel and sitting for long periods. A child’s plan may change as symptoms and hip movement change.

Contact the orthopaedic team when pain or limping increases, hip movement becomes more restricted, or the child cannot follow the recommended activity plan because of symptoms. Seek urgent assessment for sudden severe hip pain, inability to bear weight, fever with a painful hip, or a child who appears acutely unwell.

Which activities are safe for my child at this stage? How much hip movement should we practise? What changes on examination or imaging would alter treatment? How can school staff support the restrictions, and which symptoms should prompt an earlier review?