Re: my son -- prognosis & treatment

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: I too have leg perthese, however, never treated as a child. I am now 30 and have one leg 1" shorter then the other with the width being 1" in diameter thinner. This at first site may seem alarming however, I was a very good athelete when young, and still am frequently going to the gym and snow boarding, etc. I do however, have a limp but i have always compensated with a heal. I can tell you that when i get tired people asked me if my leg is hurt, i say yes and move on. As far as treatment is concerned, i never had any when little, i've been told there is a good chance that i may need a hip replacement in the future. This is because cartilage would ultimately wear away....with this in mind i try and stay away from sports that require lot's of pounding, and choose to ride bike, etc. : not sure if this helps, but i can tell you that i am a 30 year old who has never had treatment, and although a strong athelete, the length bothers me more so mentally then anything else. : regards, : Marcux : : : I believe that these are good questions for your child's doctor. I am not a doctor, nor have have any medical training, so these are my opinions only. That said, each case and each doctor is different, and therefore each treatment is different. In my case, I had surgery because my doctor felt that in the long run that my period of immobility would be shorter. As far as I can tell, the medical community is divided as to the most effective treatment. Some favor the surgery, some favor the brace/sling/etc, and a small portion has begun to argue against any treatment at all. One thing they all seem to agree on is that age plays an important factor in the long-term. That is, the younger the child is when he/she is diagnosed, the more likely it is that the long-term effects will be less severe. If your son was 7 when diagnosed, then he will probably be all right in the long term. Despite my surgery, I limped until I was able to make unconcious adjustments for the difference in leg lengths (my left leg is about 1/4" shorter than my right). The muscles will probably develop in time and with proper exercise. I am concerned that you said that your son has started limping and complaining about pain in the hip. I assume that you have mentioned this to the doctor and he has recommended surgery. You are hesitant and are therefore seeking confirmation that this is the right treatment method. All I can say is that if you are not convinced that the surgery is the best option, either seek another opinion or else hold your ground until the doctor can convince you that surgery is the only option. Once again I am NOT a doctor. These are my opinions/suggestions only. If I can do anything else, please let me know and I'll be happy to try. : : : My son is 7 & has had perthes for 4 yrs. His treatment so far has been non-intrusive --- he had a bit of traction & had an atlanta brace at night for a year. We don't restrict his activities, and he is really active. Lately (it's baseball season) he's been limping a lot, and his hip is sore most of the time. : : : 1 -- does anyone know why some doctors treat perthes more agressively? Anyone know of any research studies available that tie outcome to treatment? : : : 2. His healthy leg is more muscular around the knee/calf, and is longer. Is this normal? Once his perthes plays out will the perthes leg strengthen & catch up at all with the other leg? Will the limping stop? Or is he destined to limp for years to come unless he has surgery? : : : thanks very much.

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