Perthes’ Disease in Children in Grand Rapids, Michigan

Perthes’ disease (also called Legg-Calvé-Perthes disease or coxa plana) is a childhood hip condition seen in kids typically between 3 and 11 years old. It affects the hip joint, where the top of the thigh bone (the femoral head) normally sits like a ball inside the hip socket.

In Perthes’ disease, the blood supply to the femoral head is temporarily reduced. Without enough blood, bone cells in that area die, the bone becomes soft and weak, and the rounded “ball” can lose its normal shape.

In the Grand Rapids area, children with suspected Perthes’ disease are often evaluated by pediatric orthopedic specialists at major centers such as Corewell Health (formerly Spectrum Health) Helen DeVos Children’s Hospital, Trinity Health Grand Rapids, and University of Michigan Health–West (Metro Health).

Who Gets Perthes’ Disease?

  • Most common in children 3–11 years old
  • Boys are more likely to be affected than girls
  • Usually only one hip is involved
  • Many children eventually recover, but healing can take 2–5 years

Because Grand Rapids families are active year-round—ice skating, sledding, skiing in winter and playing soccer, baseball, and biking in warmer months—an unexplained limp or hip/knee pain is often first noticed during sports or play.

Symptoms of Perthes’ Disease

Perthes’ disease can start gradually. Common symptoms include:

  • Limping that gets worse over time, especially after activity
  • Worsening pain in:
    • The hip
    • The groin
    • The thigh
    • Or even the knee (knee pain can actually be referred pain from the hip)
  • Stiffness and reduced range of motion in the hip joint
  • Pain when putting weight on the affected leg or when moving the hip
  • Thinner thigh muscles on the affected side (from less use)
  • Slight shortening of the affected leg, which may cause uneven leg lengths

If your child in Grand Rapids has an unexplained limp, hip stiffness, or knee pain that doesn’t improve, it’s important to see your pediatrician or family doctor promptly.

What Causes Perthes’ Disease?

The exact cause is unknown. What we do know:

  • Bone needs a steady blood supply to stay healthy.
  • In Perthes’ disease, the blood flow to the femoral head is disrupted for a period of time.
  • Without enough oxygen and nutrients, the bone cells in the femoral head die (a process called avascular necrosis).

Researchers have not found a clear link to injuries, diet, or specific activities. It does not appear to be caused by anything parents or children did or did not do.

How Perthes’ Disease Progresses

Perthes’ disease usually goes through several stages over 2–5 years:

  1. Loss of blood supply

    • The femoral head becomes weak and may start to flatten.

  2. Fragmentation

    • The damaged bone breaks down and is gradually removed by the body.

  3. Reossification (regrowth)

    • New bone begins to form and reshape the femoral head.

  4. Healing and remodeling

    • The femoral head hardens and takes on its final shape.

A Critical Period for the Hip

During the early stages, the bone is soft and vulnerable to damage. If the femoral head becomes too flat or misshapen, it may not fit well in the hip socket, which can lead to early osteoarthritis in adulthood.

Treatment is focused on keeping the femoral head as round as possible while it heals.

Diagnosing Perthes’ Disease in Grand Rapids

If your child’s doctor in Grand Rapids suspects Perthes’ disease, they will:

1. Take a Detailed Medical History

Your doctor will ask about:

  • When you first noticed the limp or pain
  • What makes the symptoms worse (running, jumping, winter sports, etc.)
  • What makes them better (rest, pain medicine)
  • Any recent infections, injuries, or other health issues
  • Family history of hip problems

2. Perform a Physical Examination

The doctor will:

  • Move your child’s legs through their full range of motion
  • Look for:
    • Pain with certain movements
    • Stiffness in the hip
    • Limping or favoring one leg
    • Muscle size differences between legs

This helps identify positions that cause pain or stiffness and whether the hip joint is limited.

3. Order Imaging and Other Tests

To confirm the diagnosis and rule out other conditions, your child may need:

  • X-rays
    • The main test to see the shape of the femoral head and hip joint
  • MRI (Magnetic Resonance Imaging)
    • Provides detailed images of soft bone changes and early disease
  • Bone scan
    • Shows blood flow and bone activity if the diagnosis is unclear
  • Ultrasound
    • Sometimes used to look at joint fluid or other hip problems
  • Blood tests
    • To rule out infection or inflammatory conditions

In Grand Rapids, these tests are commonly done through hospital systems like Corewell Health, Trinity Health Grand Rapids, or U of M Health–West, all of which have pediatric imaging services.

Treatment of Perthes’ Disease in Grand Rapids

Goals of Treatment

  • Keep the femoral head as round as possible
  • Maintain the femoral head well-positioned in the hip socket
  • Reduce pain and stiffness
  • Preserve hip motion and muscle strength

Treatment depends on:

  • Your child’s age
  • The stage of the disease
  • How much the femoral head is affected
  • How well the hip moves

Non-Surgical Treatment Options

Most children are managed without surgery, especially younger children. Common treatments include:

1. Regular Monitoring

  • Ongoing visits with your pediatric orthopedic specialist
  • Periodic physical exams and X-rays
  • Close follow-up at local centers such as:
    • Helen DeVos Children’s Hospital Orthopedics (Corewell Health)
    • Trinity Health Grand Rapids Orthopedics
    • U of M Health–West Orthopedics

2. Pain Management

  • Over-the-counter pain relievers (such as acetaminophen or ibuprofen), as advised by your doctor
  • Ice or heat may be recommended for comfort

Always follow your child’s doctor’s instructions and dosing recommendations.

3. Activity Modification

To protect the soft, healing bone, your doctor may recommend:

  • Avoiding high-impact activities:
    • Running
    • Jumping
    • Competitive sports (basketball, soccer, hockey, football)
  • Choosing low-impact activities:
    • Swimming (popular in indoor pools around Grand Rapids year-round)
    • Cycling (with your doctor’s approval)
    • Gentle stretching or physical therapy exercises

During Michigan’s cold winters, when kids may be more active in ice skating, sledding, or skiing, you may need to limit or modify these activities to reduce impact on the affected hip.

4. Rest and Support Devices

At times, your child may need:

  • Short-term bed rest when pain is especially severe
  • Crutches, a walker, or a wheelchair for a period of time to reduce weight bearing on the affected leg

5. Bracing, Splints, or Plaster Casts

If hip movement is limited or X-rays show the femoral head is losing its round shape, your child’s orthopedic specialist may recommend:

  • A brace
  • A splint
  • A plaster cast

These devices help keep the femoral head better positioned in the socket while it heals.

6. Physiotherapy (Physical Therapy)

Physical therapy is an important part of treatment and is widely available in Grand Rapids through:

  • Hospital-based rehab programs (Corewell Health, Trinity Health, U of M Health–West)
  • Local pediatric physical therapy clinics

Therapy focuses on:

  • Maintaining and improving hip range of motion
  • Strengthening the hip and leg muscles
  • Teaching safe ways to move and stay active without overloading the hip

Surgical Treatment

Some children, especially older kids or those with more severe hip changes, may need surgery. This is usually done by a pediatric orthopedic surgeon.

Surgery aims to:

  • Improve how the femoral head fits in the hip socket
  • Help the femoral head stay more round as it heals
  • Reduce the risk of long-term deformity and early arthritis

Common procedures may involve:

  • Repositioning the femoral head or the hip socket
  • Using plates, screws, or other devices to hold bones in a better alignment while healing

In Grand Rapids, pediatric hip surgeries are typically performed at major centers like Helen DeVos Children’s Hospital or other regional children’s hospitals.

Long-Term Outlook for Children in Grand Rapids with Perthes’ Disease

The long-term outcome depends on:

  • Age at diagnosis
    • Younger children (often under 6) tend to have better outcomes because their bones remodel more easily.
  • Degree of damage to the femoral head
  • How well the femoral head stays round and centered in the hip socket during healing
  • How closely treatment and activity guidelines are followed

Possible long-term issues include:

  • Mild stiffness or limited hip motion
  • Differences in leg length
  • Osteoarthritis in the affected hip later in adulthood
  • In rare cases, need for hip replacement surgery later in life

However, most children respond well to treatment and are able to return to their usual daily activities, school, and many sports once the disease has healed and the hip is stable.

Living with Perthes’ Disease in Grand Rapids

Supporting a child with Perthes’ disease involves:

  • Encouraging safe, low-impact activities they enjoy
  • Working closely with your child’s orthopedic team and physical therapist
  • Following recommendations for:
    • Activity limits
    • Bracing or casting
    • Follow-up imaging
  • Maintaining a healthy weight, which can help reduce stress on the healing hip

Grand Rapids families can also take advantage of:

  • Kent County Health Department and Grand Rapids Public Health resources for general child health support and referrals
  • School-based support (504 plans or accommodations) if mobility is temporarily limited

When to Seek Medical Help

Contact your Grand Rapids pediatrician, family doctor, or urgent care if your child has:

  • A persistent limp (especially without a clear injury)
  • Hip, groin, thigh, or knee pain that lasts more than a few days
  • Stiffness or trouble moving the hip
  • Pain that wakes them at night
  • New or worsening symptoms despite rest

They may refer you to a pediatric orthopedic specialist for further evaluation.

Local Resources and Providers in Grand Rapids, MI

For evaluation and treatment of Perthes’ disease in children, consider:

  • Corewell Health – Helen DeVos Children’s Hospital (Grand Rapids)
    Pediatric orthopedics and advanced imaging

  • Trinity Health Grand Rapids
    Orthopedic services and rehabilitation

  • University of Michigan Health–West (Metro Health)
    Orthopedic specialists and pediatric care

  • Kent County Health Department
    General child health resources and community referrals

Key Points About Perthes’ Disease

  • Perthes’ disease is a childhood hip condition caused by a temporary loss of blood supply to the femoral head.
  • Symptoms include:
    • Gradually worsening limp
    • Hip, groin, thigh, or knee pain
    • Stiffness and reduced hip movement
  • The cause is unknown; it is not due to something parents or children did wrong.
  • Diagnosis involves history, physical exam, X-rays, and sometimes MRI, bone scan, ultrasound, and blood tests.
  • Treatment may include:
    • Regular monitoring
    • Pain medication
    • Physical therapy
    • Activity modification and rest
    • Bracing, splints, or casts
    • Surgery in some cases
  • Most children in Grand Rapids with Perthes’ disease, when properly treated and followed, recover well and return to normal activities.