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BACKGROUND AND OBJECTIVES: Perthes disease is a childhood precipitant to osteoarthritis of the hip, for which the etiology and mechanism are unknown. There is mounting evidence to suggest a vascular insult is responsible for disease, and it is suggested that this may have long-term implications for the vascular health of affected individuals. This study sought to use ultrasound measures to investigate vascular structure and function in children affected by Perthes disease. METHODS: This case control study encompassed 149 cases and 146 controls, frequency matched for age and gender. Endothelial function was measured by using the technique of flow-mediated dilation of the brachial artery, and alterations in arterial flow were recorded in response to an ischemic stimulus. RESULTS: There was a significant structural alteration in the vasculature among individuals with Perthes disease (resting brachial artery diameter (cases 2.97 mm versus controls 3.11 mm; P = .01), which remained even after adjusting for height. In addition, there was a notable reduction in blood velocity (cases 33.84 cm/s versus controls 37.83 cm/s; P = .01) and blood flow (cases 149.82 mL/min versus controls 184.67 mL/min; P = .001), which was independent of baseline arterial size. There was no evidence to suggest that flow-mediated dilation of the brachial artery was impaired among affected individuals (P = .71). CONCLUSIONS: Children with Perthes disease exhibit small artery caliber and reduced function, which is independent of body composition. These data imply that that Perthes disease may reflect a wider vascular phenomenon that could have long-term implications for the vascular health of affected individuals.

Original publication

DOI

10.1542/peds.2011-3269

Type

Journal article

Journal

Pediatrics

Publication Date

07/2012

Volume

130

Pages

e126 - e131

Addresses

Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.

Keywords

Brachial Artery, Humans, Ultrasonography, Doppler, Blood Flow Velocity, Body Height, Multivariate Analysis, Logistic Models, Case-Control Studies, Adolescent, Child, Child, Preschool, Female, Male, Legg-Calve-Perthes Disease