Purpose: To analyzed the heavy metals [lead (Pb) and Cadmimum (Cd)] in the peripheral blood of the perthes disease patients and to correlate their blood concentration with the clinico-radiological profile of perthes disease. Materials and Methods: In this cohort study, total 41 cases were enrolled as per strict inclusionexclusion parameters. Along withclinico-radiological examination severity of disease was done by then further further classifying them accordingly to Herring classification. The heavy metals [Pb and Cd] estimation was done using Inductively Coupled Plasma-Optical Emission Spectrometer (ICP-OES) and there blood concentration were correlated with severity of disease. Result: Total 41 patients with perthes disease patients were grouped into Group I [(with Hearing B) n=16], Group II [(with Hearing B/C) n=3] and Group III [(with Hearing C) n=22)] as per Herring lateral pillar classification. Total 30 patients (73%) showed abnormal Pb concentration while 11 (27%) patients showed normal Pb concentration. On other hand, 26 patients (63%) showed abnormal Cd concentration while 15 (37%) patients showed normal Cd concentration. Serum Pb level of 42.81±24.33 in group C and serum Cd level of 0.04±0.07 in group B/C observed were maximum concentration. Statistical significant differences were found in Pb level between B and C (radiological parameter) and Abduction and Internal rotation (clinical parameter). Significant positive correlations were found Pb level with the clinico-radiological severity of perthes disease patients. Conclusion: Heavy metal [Lead (Pb)] blood concentration is positively correlated with clinicoradiological severity of perthes disease. But to establish its causal role, further research is
