1. Perthe’s disease
Case discussion

2. 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

3. • Pain dull aching in nature
• Aggravated by exertion and sitting down in
squatting position
• No radiation
• NO h/o trauma, fever, rashes

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

5. 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

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

8. 3 months follow up
• Intensity of pain increased
• Limp increased
• Parents are worried

9. Changes in findings
• Int rot in ext – 20-20
• Int rot in flex -10-20
• Abduction – 45-60

11. To the floor