HIP PROBLEMS
HIP PROBLEMS DUE TO DESTRUCTION OR SLIPPING OF
THE CAP OF THE THIGH BONE
There are 2 different hip problems that occur most often in active children, usually boys.
1. Destruction of the cap or ‘growth center’ on the ‘head’ of the thigh bone is called
Legg-Perthes disease. It usually begins between 2 and 12 years of age. It occurs
in less than 1 of every 1,000 boys.
2. Slipping of the cap on the head of the thigh bone is less common. It happens,
suddenly or little by little, usually between 11 and 16 years of age (when the child
is growing fast).
The cause in both cases is unknown.
Destruction of the growth center results
from a temporary loss of blood supply. This
causes death of the bone.
Destruction of the growth center is
usually not related to other diseases. A
similar kind of destruction of the growth
center from loss of blood supply may be
caused by tuberculosis of the hip, sickle
cell anemia, HIV, hypothyroidism, or use of
corticosteroid medicines. A careful medical
study is advisable.
normal
‘growth center’
(cap on head of
thigh bone)
pieces of
damaged
growth
center in
Legg-Perthes
disease
sockets of
hip bone
SIGNS:
• Child begins to limp: body
dips toward affected side.
• Often he does not
complain of pain.
• Or he may feel some
pain in the knee or thigh (or
less often, hip)—although
the problem is at the hip.
• How far he can
bend or open
his hip may
become
somewhat
limited, or painful if
he tries to bend it more.
• In time the thigh becomes
thinner and weakness develops
in the muscles that lift the leg
sideways.
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DIAGNOSIS: If a child has signs of one of
these hip problems, try to get an X-ray to
find out the cause.
Treatment and progress of slipped growth center
When the growth center slips, if possible it should be put back
into place surgically, and pinned. When surgery is impossible, the
child should avoid all strenuous exercise, running, and jumping
in the hope that the growth center will not slip farther until it
becomes fused to the thigh bone (normally when the child is 16
to 18 years old). Without surgery, and especially if the slippage
is severe, a progressive, destructive arthritis is likely to result.
slipped growth center
disabled village children