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Perthes’ disease has four stages that run in a continuous cycle, which can sometimes take several years to complete.
Onset stage
This occurs when the blood supply to the top of your child’s thigh bone - the femoral head - becomes restricted. It causes the bone cells to die, and as the thigh bone softens, it can fragment or collapse. This can lead to intense inflammation and irritation, potentially affecting your child’s mobility. This stage may last a few months.
Fragmentation stage
Your child’s body then works to remove the dead part of the thigh bone and replace it with softer bone, leaving it in a weaker state. This makes the thigh bone joint prone to collapsing into a flatter position. On an X-ray, it might appear as though it’s in several pieces. This stage usually lasts one to two years.
Reconstitution stage (reossification)
This phase is often the longest and can last for several years. At this point, stronger bone tissue starts to form at the top of your child’s thigh bone. As the bone regains strength it will gradually take on a more normal, rounded shape.
Residual stage (healed)
By this stage, the bone regrowth is complete, and the top of the thigh bone will have formed its final shape. It may not be fully round again, depending on your child’s age and how much damage was caused by previous stages.
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.