Comorbidities in Perthes' disease: A case control study using the General Practice Research Database

Perry, DC; Bruce, CE; Pope, D; Dangerfield, P; Platt, MJ; Hall, AJ; (2012) Comorbidities in Perthes' disease: A case control study using the General Practice Research Database. The Journal of bone and joint surgery British volume, 94 (12). pp. 1684-9. ISSN 0301-620X DOI:

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: Perthes' disease is an osteonecrosis of the juvenile hip, the aetiology of which is unknown. A number of comorbid associations have been suggested that may offer insights into aetiology, yet the strength and validity of these are unclear. This study explored such associations through a case control study using the United Kingdom General Practice Research database. Associations investigated were those previously suggested within the literature. A total of 619 cases of Perthes' disease were included, as were 2544 controls. The risk of Perthes' disease was significantly increased with the presence of congenital anomalies of the genitourinary and inguinal region, such as hypospadias (odds ratio (OR) 4.04 (95% confidence interval (CI) 1.41 to 11.58)), undescended testis (OR 1.83 (95% CI 1.12 to 3.00)) and inguinal herniae (OR 1.79 (95% CI 1.02 to 3.16)). Attention deficit hyperactivity disorder was not associated with Perthes' disease (OR 1.01 (95% CI 0.48 to 2.12)), although a generalised behavioural disorder was (OR 1.55 (95% CI 1.10 to 2.17)). Asthma significantly increased the risk of Perthes' disease (OR 1.44 (95% CI 1.17 to 1.76)), which remained after adjusting for oral/parenteral steroid use. Perthes' disease has a significant association with congenital genitourinary and inguinal anomalies, suggesting that intra-uterine factors may be critical to causation. Other comorbid associations may offer insight to support or refute theories of pathogenesis.<br/>

Item Type: Article
Keywords: aminophylline, bambuterol, beclometasone, budesonide, cromoglycate disodium, ephedrine, fenoterol, fluticasone, formoterol, ipratropium bromide, mometasone furoate, montelukast, nedocromil, orciprenaline, salbutamol, salmeterol, steroid, terbutaline, theophylline, tiotropium bromide, zafirlukast, adolescent, article, asthma, attention deficit disorder, behavior disorder, case control study, child, comorbidity, confidence interval, controlled study, cryptorchism, data base, disease association, female, general practice, human, hypospadias, infant, inguinal hernia, major clinical study, male, newborn, pathogenesis, Perthes disease, preschool child, priority journal, risk, school child, United Kingdom, Case-Control Studies, Child, Preschool, Great Britain, Humans, Infant, Newborn, Legg-Calve-Perthes Disease, Risk Assessment, Risk Factors, Adolescent, Case-Control Studies, Child, Child, Preschool, Comorbidity, Female, General Practice, Great Britain, Humans, Infant, Infant, Newborn, Legg-Calve-Perthes Disease, epidemiology, etiology, Male, Risk Assessment, Risk Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 23188912
Web of Science ID: 311619700020


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