{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:06:47Z","timestamp":1792400807150,"version":"4.4.0"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>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).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2011-3269","type":"journal-article","created":{"date-parts":[[2012,6,5]],"date-time":"2012-06-05T09:47:46Z","timestamp":1338889666000},"page":"e126-e131","source":"Crossref","is-referenced-by-count":34,"title":["Abnormalities of Vascular Structure and Function in Children With Perthes Disease"],"prefix":"10.1542","volume":"130","author":[{"given":"Daniel C.","family":"Perry","sequence":"first","affiliation":[{"name":"Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom;"},{"name":"Department of Children's Orthopaedic Surgery, Alder Hey Hospital, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Green","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom;"},{"name":"School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin E.","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Children's Orthopaedic Surgery, Alder Hey Hospital, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pope","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Liverpool, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Dangerfield","sequence":"additional","affiliation":[{"name":"Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jane","family":"Platt","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Hall","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Jones","sequence":"additional","affiliation":[{"name":"Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,7,1]]},"reference":[{"issue":"3","key":"2021120821260821500_B1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/aje\/kwr293","article-title":"Racial and geographic factors in the incidence of Legg-Calv\u00e9-Perthes\u2019 disease: a systematic review.","volume":"175","author":"Perry","year":"2012","journal-title":"Am J Epidemiol"},{"issue":"7","key":"2021120821260821500_B2","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2106\/00004623-198163070-00006","article-title":"The natural history of Legg-Calv\u00e9-Perthes disease.","volume":"63","author":"Stulberg","year":"1981","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"2021120821260821500_B3","doi-asserted-by":"crossref","first-page":"961","DOI":"10.2106\/00004623-197658070-00011","article-title":"The arterial supply of the developing proximal end of the human femur.","volume":"58","author":"Chung","year":"1976","journal-title":"J Bone Joint Surg Am"},{"issue":"11","key":"2021120821260821500_B4","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1302\/0301-620X.90B11.20318","article-title":"Perthes\u2019 disease and the search for genetic associations: collagen mutations, Gaucher\u2019s disease and thrombophilia.","volume":"90","author":"Kenet","year":"2008","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"2021120821260821500_B5","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2008-0307","article-title":"Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of Legg-Calv\u00e9-Perthes disease.","volume":"122","author":"Bahmanyar","year":"2008","journal-title":"Pediatrics"},{"issue":"8","key":"2021120821260821500_B6","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1093\/rheumatology\/ken206","article-title":"Non-traumatic necrosis of bone (osteonecrosis) is associated with endothelial cell activation but not thrombophilia.","volume":"47","author":"S\u00e9guin","year":"2008","journal-title":"Rheumatology (Oxford)"},{"issue":"6","key":"2021120821260821500_B7","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1179\/102453308X343509","article-title":"Thrombomodulin and GFC levels in Legg-Calve-Perthes disease.","volume":"13","author":"Aksoy","year":"2008","journal-title":"Hematology"},{"key":"2021120821260821500_B8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0002-9149(97)00381-0","article-title":"New insights into the pathogenesis and prevention of acute coronary syndromes.","volume":"79","author":"Shah","year":"1997","journal-title":"Am J Cardiol"},{"issue":"25","key":"2021120821260821500_B9","doi-asserted-by":"crossref","first-page":"3205","DOI":"10.1161\/CIRCULATIONAHA.106.674804","article-title":"Tobacco smoke exposure is associated with attenuated endothelial function in 11-year-old healthy children.","volume":"115","author":"Kallio","year":"2007","journal-title":"Circulation"},{"issue":"3","key":"2021120821260821500_B10","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1056\/NEJM199601183340303","article-title":"Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults.","volume":"334","author":"Celermajer","year":"1996","journal-title":"N Engl J Med"},{"issue":"3","key":"2021120821260821500_B11","doi-asserted-by":"crossref","first-page":"498","DOI":"10.2106\/00004623-196749030-00008","article-title":"Birth weight and Legg-Perthes disease.","volume":"49","author":"Molloy","year":"1967","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"2021120821260821500_B12","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1302\/0301-620X.60B4.711791","article-title":"Perthes\u2019 disease. 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