What symptoms do children have?
In children, femoral head necrosis is also known as Perthes disease or juvenile femoral head necrosis. Children between the ages of four and eight years are particularly affected. The main symptom of Perthes’ disease is a limping that is often dependent on physical exertion.
In children, the pain radiates mainly into the thigh and up to the knee joint. For this reason, juvenile necrosis of the femoral head should always be considered when dealing with knee pain in children. Children are also often conspicuous by their laziness when walking.
Movement restrictions are observed above all in the internal rotation and in the lateral lifting of the leg. In 20-30 percent of cases, the complaints occur on both sides. Often there is a time lag between the symptoms on the other side and the laziness of walking.
- Therapy for Perthes disease
- Causes of femoral head necrosis
Associated symptoms
The reduced blood flow to the femoral head can lead to remodelling processes in the bone. These remodeling processes can lead to a difference in leg length over time. In Perthes’ disease – i.e. necrosis of the femoral head in children – the necrosis can lead to a shortening of the femoral neck. This is caused by the growth plate, which is impaired by circulatory disorders and leads to disturbed length growth. The difference in leg length can lead to a visible limping.
What are the typical symptoms of femoral head necrosis?
Adult femoral head necrosis, which usually develops between the ages of 35 and 45 and affects men more frequently than women, is often characterized by very unspecific symptoms that are not considered to be of great significance. A pulling in the groin area (the area where the femoral head, which in this disease can partially die off due to reduced blood flow, is located), which is comparable to a sore muscle, is often one of the first signs. Sometimes, a shooting, stabbing pain in the groin area is also described.
Paradoxically, diseases of the hip joint can often also manifest themselves through pain in the knee joint area, especially in children, but this possibility must also be considered in adults. Often, further restrictions are only noticed as the disease progresses, such as reduced or painful mobility in the hip joint, and usually the internal rotation is affected first. The limitation of movement increases more and more, the affected person feels increasingly restricted in everyday life, he relieves the leg, possibly so much so that a relieving limp with increased strain on the healthy leg can be observed.
In the worst case, the affected leg can no longer be loaded at all. It is important to note that necrosis of the femoral head often (in about half of the cases) manifests itself on both sides, which does not mean that both sides have to be affected at the same time. Even after a period of years, one side may still be affected by the other.
It should not be forgotten that there are certainly cases of femoral head necrosis in which the disease progresses asymptomatically for a long time (i.e. without revealing itself to the person affected by one of the above-mentioned symptoms) and then leads directly to so-called secondary arthrosis, i.e. irreversible joint destruction (destruction), which is manifested by increasing starting pain (i.e. pain when walking after sitting or lying down for a long time) and, as the arthrosis progresses, by pain under stress and later also pain at rest.
