From the Research
Perthes disease in an 11-year-old child typically presents with hip pain, limping that worsens with activity, limited hip movement, and muscle atrophy in the thigh, and treatment should focus on preserving the femoral head shape while it heals over 2-4 years, with a combination of physical therapy, activity modification, and possibly non-weight bearing with crutches during painful episodes, as recommended by the most recent study 1. The symptoms of Legg-Calve-Perthes (LCP) disease in an 11-year-old child may include:
- Hip pain
- Limping that worsens with activity
- Limited hip movement
- Muscle atrophy in the thigh Treatment options for LCP disease in an 11-year-old child may include:
- Physical therapy to maintain range of motion
- Activity modification to avoid high-impact activities
- Non-weight bearing with crutches during painful episodes
- Pain management with NSAIDs like ibuprofen (10mg/kg every 6-8 hours) or naproxen (5-7mg/kg twice daily)
- Containment methods such as bracing with a Scottish Rite orthosis or surgical interventions like femoral or pelvic osteotomy to properly position the femoral head within the acetabulum The child should be monitored with regular X-rays every 3-6 months to assess healing progress, as recommended by 2. It is essential to note that the prognosis is generally less favorable for children diagnosed after age 8, so this 11-year-old requires close monitoring, as stated in the example answer. The disease results from temporary interruption of blood supply to the femoral head, causing bone death and subsequent fragmentation before eventual healing and remodeling, which explains the lengthy recovery process and need for interventions to maintain proper hip joint development, as described in 1. The most recent and highest quality study 1 recommends a combination of physical therapy, activity modification, and possibly non-weight bearing with crutches during painful episodes, which should be the primary treatment approach for an 11-year-old child with LCP disease.