{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T12:23:33Z","timestamp":1771849413370,"version":"3.50.1"},"reference-count":0,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perthes\u2019 disease is a puzzling childhood hip disorder for which the aetiology is unknown. It is known to be associated with socioeconomic deprivation. Urban environments have also been implicated as a risk factor, however socioeconomic deprivation often occurs within urban environments and it is unclear if this association is the result of confounding. The objective of the current work was to gain a greater understanding of the influence of the urban\/rural environment in Perthes\u2019 disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a descriptive observational study using the Scottish Morbidity Record, based in Scotland, UK using data from 2000\u20132010. A total of 443 patients with a discharge diagnosis of Perthes\u2019 disease were included. Socioeconomic deprivation was determined using the Scottish Index of Multiple Deprivation, and exposure to the \u2018urban environment\u2019 was recorded based on the Scottish Urban\u2013Rural Classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a strong association with socioeconomic deprivation, with rates among the most deprived quintile more than twice those of the most affluent (RR 2.1 (95% CI 1.5 to 2.9)). Urban areas had a greater rate of Perthes\u2019 disease discharges (RR 1.8 (95% CI 1.1 to 3.2)), though this was a reflection of greater deprivation in urban areas. Stratification for socioeconomic deprivation revealed similar discharge rates in urban and rural environments, suggesting that the aetiological determinants were not independently associated with urban environments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The occurrence of Perthes\u2019 disease within urban environments is high, yet this appears to be a reflection of higher socioeconomic deprivation exposure. Disease rates appear equivalent in similarly deprived urban and non-urban areas, suggesting that the determinant is not a consequence of the urban environment.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2012-302143","type":"journal-article","created":{"date-parts":[[2012,10,29]],"date-time":"2012-10-29T13:58:06Z","timestamp":1351519086000},"page":"1053-1057","source":"Crossref","is-referenced-by-count":27,"title":["Perthes\u2019 disease of the hip: socioeconomic inequalities and the urban environment"],"prefix":"10.1136","volume":"97","author":[{"given":"Daniel C","family":"Perry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin E","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Pope","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Dangerfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Jane","family":"Platt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,10,27]]},"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2012-302143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T08:17:49Z","timestamp":1601108269000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2012-302143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,27]]},"references-count":0,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2012,11,19]]},"published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1136\/archdischild-2012-302143"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2012-302143","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,10,27]]}}}