Perthes disease - a disease of the femur and the hip joint in children. The children themselves are generally not able to describe the first symptoms of the disease. In the early stages of Perthes' disease in a child may at times appear limp. Further, the disease progresses and lameness increases. Then, the child begins to feel pain in the knees Living with pain in the knees: a walk to facilitate , Thigh or groin area when the legs presses the body weight and / or movements of the hip joint. Further, the hip joint may become less mobile. If a child is sick for a long time, his bad leg would be slightly shorter and thinner sound.

Despite the pain and lameness, children with Perthes' disease generally healthy. Perthes disease usually affects children between the ages of three and eleven years. It is more common in boys than in girls. More than 75% of patients struck by only one hip joint.

Causes of Perthes' disease is unknown. The disease goes through several stages of development. First, there is a temporary cessation of blood flow to the femoral head, resulting in the latter slowly softens and collapses. Because of this, the femoral head, OK - round, flat or becomes deformed, becoming like a mushroom. Then, the bone begins to pinch, sometimes largely deformed.

Most children with Perthes' disease recover completely, although it may take two to five years, while the damaged bone to recover. If the femoral head was not seriously deformed femur and the hip joint will function normally. More serious deformation may restrict the mobility of the joint and early arthritis.

Diagnostics

In the early stages, as a rule, Perthes disease can not be identified with the help of X-rays. For a more accurate diagnosis using ultrasound and magnetic resonance imaging. If the X-ray image are clearly visible typical of Perthes' disease changes, the use of other methods of diagnosis is not required.

Treatment

The objectives of treatment for Perthes' disease - to reduce pain and stiffness in the joints and prevent deformation of the femoral head. Selection of treatments depends on the child's age and severity of disease.

Children under the age of five years with milder forms of Perthes' disease is generally recommended to avoid strenuous physical activity, and the appearance of pain in the joints Joint pain - how to understand what is going on?   - A lot of rest. Other treatments are rarely used.

Children older than five years with Perthes' disease sometimes have to wear special orthopedic devices - usually within one or two years. With a very strong deformation of the femoral head, and if the child refuses to wear retainers may be necessary surgery.

The treatment period can be psychologically very difficult for children and their parents. Limiting activity can cause a child's irritability Irritability - you try to control my temper   and increased anxiety Anxiety - how to distinguish normal from disease? . Parents need to show understanding and patience; if necessary, seek the advice of a child psychologist.

Koenig's disease - a disease of the joints, in which a piece of cartilage with an underlying thin layer of bone is peeled at the end of the bone. Cause a decrease in blood flow to the end of the bone disease Koenig develops mainly in young men, often after a joint injury. The most common disease Koenig affects the knee joint, but often develops in the elbow, shoulder and hip joints. If exfoliated fragments of cartilage and bone tissue rather close fitting to the bone, the symptoms may be absent. Often these lesions heal on their own. In some cases, however, the disease causes symptoms Koenig and requires treatment. In some cases, the disease causes Koenig developing osteoarthritis.

Symptoms

Koenig symptoms of the disease are:

• Pain. Usually, pain appears as a result of different physical activity, sometimes - even after a very small loads;
• Crunch in the joints;
• The weakness of the joints;
• Reducing the range of motion. For example, some patients with the disease Koenig can not fully straighten the arm or leg;
• Swelling, and pain in the joint of the skin.

When these symptoms are advised not to put off a visit to the doctor.

Causes

Koenig's disease is caused by a decrease in blood flow to the affected bone. This usually occurs as a result of trauma. It is assumed that there are genetic features that make a person more susceptible to developing the disease Koenig.

Risk factors

• Age. Koenig's disease most commonly occurs in people aged 10 to 20 years.
• Paul. The likelihood of developing the disease in men Koenig two to three times higher than in women.
• Sports. Gym sports that require sudden changes of direction, jumping and throwing, may increase the risk of developing the disease Koenig.

Diagnostics

X-ray examination. Using X-ray you can see a variety of abnormalities in the joints. If you hit the knee or elbow, the doctor usually takes pictures of healthy and sick joints, and then compares them.

Computed tomography (CT) to determine where it was detached bone and cartilage.

Magnetic resonance imaging (MRI) provides a detailed picture of both soft and hard tissues. Often used to make a final decision in favor of conservative or surgical treatment.

The first is usually recommended conservative treatment, such as rest and physical therapy. Under rest here means a temporary abandonment of intense exercise. Physical therapy usually is to perform special exercises recommended by the physiotherapist.

If conservative treatments do not help, it can be assigned to surgery. In many cases, surgery is performed atroskopicheskie - with a special tool with a camera on the end. For such an operation does not require large incisions, and the patient's recovery is quite fast.