MSK: Perthe's Disease: Free MSRA Podcast

🎧FREE MSRA PODCAST –Perthes Disease: A Limping Clue to Avascular Necrosis in KidsToday we’re divingdeep into Perthes Disease (Legg-Calvé-PerthesDisease) — a classic MSRA paediatrics/orthopaedics topic that’s oftenmissed early. We’ll explore the key features,diagnosis, and management strategies, plus mnemonics like BHP and AI OUTto lock in your revision. 🧠Key Learning Points –Perthes Disease for the MSRA📌Definition• Perthes is a paediatric hip disorder caused by temporary disruption of blood supply to thefemoral head → leads to avascular necrosis 📌Causes & RiskFactors• Exact cause unknown• Risk factors: – Boys (4:1 or 5:1 ratio → BHP: Boys Have Perthes) – Aged 4–10 – Low birth weight, maternal smoking, possible geneticcomponent – Clotting disorders, sickle cell disease 📌PathophysiologyBlood supply interrupted → bone cell death (AVN)Revascularisation & bone repairRisk of femoral head flattening or deformity if containment lost💡 Think of the femoral head undergoing a “bad renovation” 📌Clinical Features• Gradual onset hip/groin/thigh/knee pain• Limp, often antalgic• Reduced hip movements, esp. abduction + internal rotation → 🧠Mnemonic: “AI OUT”• Referred pain to knee can delay diagnosis• No systemic signs(e.g. fever) 📌Differentials• Transient synovitis (temporary)• Septic arthritis (urgent, febrile)• Juvenile idiopathic arthritis (JIA)• Trauma/fracture 📋Diagnosis &Investigations🩻X-ray (AP + frog-leg views): may show joint spacewidening early → later: fragmentation,flattening🧲MRI: gold standard for early detection of AVN🧪 Rule out infection (e.g. hip aspiration if septicarthritis suspected) 🩹Management Strategy🎯 Goals: pain relief, maintain motion, preserve containment (keep femoral head in acetabulum)🔹Non-operative (esp. <6 yrs): – Activityrestriction – Physiotherapy – Crutches, possibly bracing – NSAIDs for pain🔹Surgery: – Osteotomy (femoral or pelvic) – Shelf/valgus osteotomy – Hip arthrodiastasis (rare) – Sometimes hip arthroscopy 📉Prognosis &Complications✅Better outcomes in younger children (<6 yrs)❌ Long-term risks: – Deformed femoral head (e.g. coxa magna, plana,breva) – Leg length discrepancy – Hip stiffness – Early osteoarthritis (by 40s–60s in ~50%) – Hip incongruity → impaired mechanics →arthritis 📎More MSRA Resources –Perthes Disease📝 Revision Notes:https://www.passthemsra.com/topic/perthes-disease-revision-notes-2/🧠 Flashcards:https://www.passthemsra.com/topic/perthes-disease-flashcards-2/📖 Accordion Q&A:https://www.passthemsra.com/topic/perthes-disease-accordion-qa-notes-2/🎯 Rapid Quiz:https://www.passthemsra.com/topic/perthes-disease-rapid-quiz-2/🧪 Quiz Bank:https://www.passthemsra.com/quizzes/perthes-disease/ 🌐 More tools and free content:✅PassTheMSRA.com – Complete course, flashcards, quizzes, videos🔓FreeMSRA.com – 100% free notes, podcast links, blog posts Hashtags#MSRA#PerthesDisease #PaediatricsMSRA #MSRARevisionNotes #MSRAQuiz #MSRAFlashcards#MSRAAccordions #MSRATextbook #AvascularNecrosis #HipPainChild#MSRAQuestionBank #MSRAOnlineRevision