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Orthop Clin North Am. 2011 Jul;42(3):279-83, v. doi: 10.1016/j.ocl.2011.03.002. Epub 2011 May 12.

The epidemiology and etiology of Perthes disease.

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Department of Child Health, University of Liverpool, Liverpool, UK.


The incidence of Perthes disease varies markedly both between countries and within countries down to a local level. The disease is more common in white than in Asian or black African children. The disease is associated with deprivation; with a steep disease gradient across social class groups. This epidemiology alongside the lack of concordance in twins suggests a strong environmental etiology, with little evidence to suggest a genetic predisposition. Children are frequently short, with a growth pattern described as "rostral-sparing". A propensity to associated congenital anomalies suggests an intrauterine cause.

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