Legg-Calvé-Perthes disease in the UK: Geographic and temporal trends in incidence reflecting differences in degree of deprivation in childhood

Perry, Daniel C., Bruce, Colin E., Pope, Daniel, Dangerfield, Peter, Platt, Mary Jane and Hall, Andrew J. (2012) Legg-Calvé-Perthes disease in the UK: Geographic and temporal trends in incidence reflecting differences in degree of deprivation in childhood. Arthritis & Rheumatism, 64 (5). pp. 1673-1679. ISSN 1529-0131

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Abstract

Objective Little is known about Legg-Calvé-Perthes disease, a common childhood precursor to osteoarthritis of the hip. This study was undertaken to analyze the incidence of Legg-Calvé-Perthes disease in the UK, with respect to geographic and temporal trends over a 19-year period. Methods The General Practice Research database was analyzed to identify incident cases between 1990 and 2008 in children ages 0–14 years. Incidence rates were calculated by year and by region (National Health Service Strategic Health Authority regions in England, and Scotland, Wales, and Northern Ireland), and the association with regional markers of deprivation examined. Results Over the 19-year period there was a dramatic decline in Legg-Calvé-Perthes disease incidence, with annual rates among children 0–14 years old declining from 12.2 per 100,000 to 5.7 per 100,000 (P < 0.001). There was also marked geographic variation, with incidence rates in Scotland more than twice those in London (10.39 [95% confidence interval 8.05–13.2] versus 4.6 [95% confidence interval 3.4–6.1] per 100,000 0–14-year-olds). A more rapid decline in incidence was apparent in the Northern regions compared to Southern regions. The quintile with the highest degree of deprivation had the highest disease incidence (rate ratio 1.49 [95% confidence interval 1.10–2.04]) and, with the exception of London, regional incidence showed a strong linear relationship with regional deprivation score (P < 0.01). Conclusion The incidence of Legg-Calvé-Perthes disease in the UK has a strong North-South divide, with a greater disease incidence within the Northern regions of the UK. There was a marked decline in incidence over the study period, which was more marked in Northern areas. The declining incidence, along with the geographic variation, suggests that a major etiologic determinant in Legg-Calvé-Perthes disease is environmental and closely linked to childhood deprivation.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Users 2731 not found.
Date Deposited: 22 Jun 2012 12:27
Last Modified: 10 Nov 2022 11:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/38961
DOI: 10.1002/art.34316

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