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Perthe’s disease

Date post: 01-Jun-2015
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Perthe’s disease Case discussion
Transcript
Page 1: Perthe’s disease

Perthe’s disease

Case discussion

Page 2: Perthe’s disease

case

• Sandhya Gaire• 6 yr 7 mths old girl• Grade I student• Informant uncle• c/o- pain rt groin X 6-7 mths• occasional limp

Page 3: Perthe’s disease

• Pain dull aching in nature• Aggravated by exertion and sitting down in

squatting position• No radiation• NO h/o trauma, fever, rashes

Page 4: Perthe’s disease

Examination

• Gait- antalgic on exertion• Cannot sit cross legged• Can squat• Trendelenberg test negative• Tenderness +ve on anterior hip jt line

Page 5: Perthe’s disease

Range of motion

• Flexion 140-140• Extension 10-15• Adduction 40-40• Abduction 30-60• Ext rot in ext – 30-30• Ext rot in flex – 50-50• Int rot in ext – 10-20• Int rot in flex – 0-20

Page 6: Perthe’s disease

• Wasting of thigh 2cm• Wasting of calf 0.5 cm• No LLD• Telescoping test –ve• Sectoral sign +ve

Page 7: Perthe’s disease
Page 8: Perthe’s disease

3 months follow up

• Intensity of pain increased• Limp increased• Parents are worried

Page 9: Perthe’s disease

Changes in findings

• Int rot in ext – 20-20• Int rot in flex -10-20• Abduction – 45-60

Page 10: Perthe’s disease
Page 11: Perthe’s disease

To the floor

What next?


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