{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:14:57Z","timestamp":1790345697636,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The precise pathological mechanisms through which obesity increases the risk of slipped capital femoral epiphysis (SCFE) remain unclear. We aimed to investigate the impact of childhood obesity on the morphology of the capital femoral epiphysis in children and adolescents without hip disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective cross-sectional study that included 4,888 children and adolescents 7 to 19 years of age who underwent a hip or pelvic computed tomography (CT) scan, most for abdominal pain, between 2004 and 2022. Automated 3D-CT analysis assessed epiphyseal tubercle height, superior and anterior peripheral cupping, and epiphyseal tilt. Generalized additive models (GAMs) were used to examine the associations between epiphyseal morphology and age, stratified by obesity status, while adjusting for sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We observed distinct age-related trajectories of femoral-head morphology related to obesity. Subjects with obesity demonstrated a larger femoral-head diameter from ages 7 to 15 years (obese versus normal-weight differences: 0.3 to 2.3 mm), smaller epiphyseal tubercle height after 9 years of age (normal-weight versus obese differences: 0.4% to 1.3%), and a more posteriorly tilted epiphysis, as assessed by a smaller axial tilt angle (normal-weight versus obese differences: 4\u00b0 to 1\u00b0) from ages 7 to 15 years. In subjects with obesity, the superior epiphyseal cupping was larger before 11 years of age (obese versus normal-weight differences: 1.6% to 0.4%), but after 13 years of age, the superior epiphyseal cupping was smaller (normal-weight versus obese differences: 0.2% to 2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Children with obesity demonstrated a smaller epiphyseal tubercle height, greater posterior epiphyseal tilt, and reduced superior cupping compared with children of normal weight. These anatomical differences may contribute to the increased risk of SCFE in patients with obesity and offer potential imaging markers for earlier identification and risk-stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.01472","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T19:00:21Z","timestamp":1755198021000},"page":"2102-2109","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Impact of Childhood Obesity on Capital Femoral Epiphysis Morphology"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-3100","authenticated-orcid":false,"given":"Eduardo N.","family":"Novais","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2296-9985","authenticated-orcid":false,"given":"Mohammadreza","family":"Movahhedi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8877-622X","authenticated-orcid":false,"given":"Nazgol","family":"Tavabi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-7592","authenticated-orcid":false,"given":"Mallika","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4843-3329","authenticated-orcid":false,"given":"Shanika","family":"De Silva","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6271-6085","authenticated-orcid":false,"given":"Sarah","family":"Bixby","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Harvard Medical 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A case series study","volume":"88","author":"Elbeshry","year":"2022","journal-title":"Acta Orthop Belg."},{"issue":"6","key":"bib34-20250917","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1302\/0301-620X.95B6.30806","article-title":"Slipped capital femoral epiphysis associated with vitamin D deficiency: a series of 15 cases","volume":"95-B","author":"Madhuri","year":"2013","journal-title":"Bone Joint J."},{"issue":"10","key":"bib35-20250917","doi-asserted-by":"crossref","first-page":"865","DOI":"10.2106\/JBJS.16.00718","article-title":"Leptin Elevation as a Risk Factor for Slipped Capital Femoral Epiphysis Independent of Obesity Status","volume":"99","author":"Halverson","year":"2017","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.01472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:51:30Z","timestamp":1787752290000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.01472"}},"subtitle":["A Large-Scale, Automated 3D-CT Study and Potential Implications for SCFE Pathogenesis"],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":35,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.24.01472","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]}}}