الفهرس 
Introduction
Historical backgroundOnly 14 pages are availabe for public view
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Abstract
• Perthes’ disease occurs as a consequence of idiopathic avascular necrosis of the proximal femoral epiphysis. • It mainly affects children between 3–12 years of age, primarily 4–8 years, with boys affected about four times more frequently than girls with a familial incidence of about 10 %, bilateral involvement is present in up to 20% of children and usually asymmetrical. It tends to affect children of lower social classes in strong association with low income and a link to low birth-weight and other deprivation measures. Other factors which may contribute to development of Perthes’ disease include: impaired vascular supply of femoral head, increased intra-articular pressure, increased intra-osseous pressure, presence of coagulation disorder and reduced level of growth hormone. • The clinical features vary depending on the age of the child, the stage of disease and the extent of involvement of the femoral head. Usually the child presents with an intermittent limp, which may be painful and made worse with activity. Diagnosis of early Perthes’ disease is often suspected from radiography, other diagnostic tools include: ultrasound, computed tomography, bone scintigraphy, arthrography and magnetic resonance imaging. The Screening protocol for detection of ischaemic disease of the growing hip (IDGH ) and prevention of Perthes’ disease represents a new era in the early management of cases before evolution to the classic features of Perthes’ disease using both ultrasound and magnetic resonance imaging. • Based on the extensive review of the literatures, the appropriate time for intervention and to begin definitive treatment is when the sphericity of the femoral head is still intact, which means at the time that diagnosis has been made. Regardless of the mode of treatment decided upon, therefore, it appears that results would be markedly improved if treatment is begun and rigidly adhered to while femoral head sphericity is still present.