The uncertainty of Perthes continues to be an ongoing story. As new research is published, another piece of the puzzle becomes available to figure out the many facets to the disease. Recently, a research study conducted by IPSG members at Texas Scottish Rite Hospital for Children, doctors Kim and Herring, along with other researchers, showed a high prevalence of obesity in patients with Perthes.  This perspective of Perthes is now a topic of discussion as Perthes disease was once thought to affect thin, active children, especially boys.

This study is new and interesting as it is one of the first of its kind to look at the common presence of obesity in children with Perthes, its effect on treatment, and how socioeconomic status correlates. The study specifically examined 150 patients with Perthes disease between 2009 and 2014, which coincides with the current obesity epidemic in the United States. The patients were grouped based on age and body mass index (BMI) using the Center of Disease Control (CDC) pediatric BMI calculator. The date range was selected in order to be consistent with the most recent National Health and Nutrition Examination Survey from 2011 to 2012 regarding obesity.

A key finding was that obesity could delay the presentation of Perthes patients to clinic. The study found that children with high BMI were diagnosed at a later stage of the disease compared to those with normal BMI. This finding raises the question of whether obesity itself delays the diagnosis of Perthes or other factors such as delayed access to medical care come into play.

In terms of treatment, children with high BMI were at least 2 times less likely than children with normal BMI to undergo surgery, including a hip arthrogram, casting or a bony procedure (femoral/pelvic osteotomy, etc.). The authors of the study believed that the lower rate was due to these patients presenting at a later stage of disease when it would be too late to do surgery.

To summarize, the information collected from the study suggest that obesity is highly prevalent in children with Perthes disease, at least in the state of Texas. The authors note that more studies are needed to confirm whether similar trends are found in other regions of USA and other countries.  Meantime, it is important for families with young children to not only be aware of Perthes, but also for doctors to understand the high prevalence of obesity in children with Perthes.

To read the full article, please click this link: http://www.ncbi.nlm.nih.gov/pubmed/27471901