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черкесске","retina":false,"avatarId":"0","isHermione":false,"isMacOS":false,"tld":"com.tr","isEmbeddedFuturis":false,"isLoggedIn":false,"brand":"yazeka","reqId":"1759719373323540-11751273347159186714-balancer-l7leveler-kubr-yp-sas-105-BAL","device":{"isIOS":false,"platform":"desktop"},"expFlags":{"isFootnoteDetails":true,"isFootnoteRedesignDivided":true,"futurisMultiqueryFlag":true}},"dialogStoreProps":{"baseUrl":"","baseUrlWs":"","orderedPairUUID":["Question"],"requestResponsePairs":{"data":{"Question":{"userMessage":"Болезнь Пертеса: что это?","markdown":"**Болезнь Пертеса** (болезнь Легга-Кальве-Пертеса, остеохондропатия головки бедра) — **нарушение кровоснабжения головки бедренной кости у детей** [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/)[3](https://polyclinika.ru/tech/bolezn-pertesa-stadii-simptomy-lechenie/)[7](https://doct.ru/articles/bolezn-pertesa.html). Из-за недостатка питания костная ткань начинает разрушаться (развивается асептический некроз) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Затем ткань восстанавливается, но процесс восстановления может идти с деформацией головки, особенно если ребёнок старше 6–8 лет [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Это может повлиять на нормальную работу тазобедренного сустава и со временем привести к артрозу [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). \n\nЧаще всего болезнь возникает в возрасте от 4 до 10 лет, преимущественно у мальчиков [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Как правило, поражается только один сустав, реже — оба [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/).\n\n\n\n## Причины\nТочные причины неизвестны [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Некоторые факторы, повышающие риск развития заболевания: \n* микротравмы и физическая перегрузка [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* задержка костного развития [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* нарушения свёртываемости крови [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* наследственная предрасположенность [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/).\n\n## Симптомы\nЗаболевание начинается постепенно [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Некоторые симптомы: \n* хромота (даже без выраженной боли) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* боль в тазобедренном суставе, иногда отдающая в колено [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* ограничение движений в бедре (особенно при разведении и вращении) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* ощущение усталости при ходьбе [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* слабость мышц и визуальное укорочение конечности со стороны поражения [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/).\n\n## Диагностика\nВрач ставит диагноз на основе жалоб, осмотра и результатов обследований [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/): \n* **Рентгенография** — позволяет выявить характерные изменения, но не всегда сразу (может потребоваться повтор через 1–2 месяца) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). \n* **МРТ** — позволяет увидеть болезнь на ранней стадии, когда изменения ещё не видны на рентгене [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). \n* **Анализы крови** — для исключения других причин (воспаления, инфекции, ревматических заболеваний) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/).\n\n## Лечение\nЛечение зависит от возраста, степени поражения и стадии болезни [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Оно может быть консервативным (без операции) или хирургическим [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). \n\n**Консервативное лечение** проводится чаще у детей младшего возраста (до 6–8 лет) при умеренных изменениях [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). Включает [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/): \n* ограничение физических нагрузок — исключают бег, прыжки, активные игры [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* лечебную физкультуру — упражнения для сохранения подвижности и укрепления мышц [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* использование костылей или специальных шин — снижают нагрузку на сустав и удерживают ногу в правильном положении [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* обезболивающие и противовоспалительные средства — снимают боль и воспаление [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/); \n* препараты для поддержки костной ткани — например, бисфосфонаты (замедляют разрушение костей и стимулируют их восстановление) [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). \n\n**Хирургическое вмешательство** назначают строго по показаниям, например, если произошёл вывих, обильная деформация, перелом головки бедренной кости [10](https://medcentr-Sochi.ru/revmatolog/bolezn-pertesa.html). \n\n**Прогноз**: у детей до 6 лет болезнь часто проходит без тяжёлых последствий [1](https://cmrt.ru/stati/kak-lechit/bolezn-pertesa/). 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