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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two Shetland Sheepdogs that did not have a history of trauma were referred because of a gradual onset of lameness in the hind limbs. Bilateral slipped capital femoral epiphysis was diagnosed. Separation of the proximal femoral epiphysis that is not associated with trauma is recognized as a distinct clinical syndrome in adolescent human beings and swine, causing a condition called epiphysiolysis. The precise cause of this type of injury is unknown. Histologic lesions observed in the growth plates could have been the result of an abnormally high mechanical load imposed by obesity. It is not known whether cartilaginous lesions observed in the physis of 1 dog represented a preexisting cartilaginous defect (dyschondroplasia) or a late stage of repair after separation of the capital femoral epiphysis.
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PMID:Bilateral epiphysiolysis of the femoral heads in two dogs. 910 23

Slipped capital femoral epiphysis is rare in Asiatic Indonesian-Malays. Seven cases (9 hips) of this condition in Ramathibodi Hospital including five boys (average age, 12.5 years) and two girls (average age, 13 years) were reviewed. Most of the cases (4 out of 7) were acute on chronic and mild slips. No endocrine disorder was observed in all cases. All of the patients had a body weight above the mean of the normal population, four of which were obese. For the treatment, a single screw fixation including one case with cancellous and six cases with cannulated type were used. In the follow-up of average 2.5 years, six cases had satisfactory results. Avascular necrosis occurred in one case with mild and chronic slips in which a cancellous screw was used. It is concluded that obesity is the important factor related to the etiology in this study and probably is the same in other developing countries. The effect of a cancellous screw causing avascular necrosis is still questionable.
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PMID:Slipped capital femoral epiphysis in Ramathibodi Hospital. 927 74

African teenagers with slipped capital femoral epiphysis (SCFE) not infrequently also have genu valgum (knock-knee). Because we had previously demonstrated metabolic bone disease attributable to dietary calcium deficiency in black teenagers with genu valgum, we examined 29 black teenagers (15 male, 14 female) with SCFE for metabolic bone disease. Each patient had an iliac crest bone biopsy taken (after double tetracycline labeling) for routine histomorphometry, and blood and urine samples for bone biochemistry. Spinal bone mineral density was measured in 13 patients. Compared to reported data, we found our patients to be sexually more immature, older, at least as obese, and to have more severe and more frequently bilateral hip disease. Eighty percent of the children took dairy products only once or twice a week or less frequently, and 37.9% had genu valgum. Compared with race- and age-matched South Africans, bone biopsies in our patients showed lower bone volume (BV/TV, p = 0.0003), wall thickness (p = 0.0002), and trabecular thickness (Tb.Th, p = 0.0002), and a tendency to greater trabecular spacing (Tb.Sp, p = 0.053). Lower osteoid volume (OV/BV, p = 0.0001), osteoid surface (OS/BS, p = 0.0001), osteoid thickness (O.Th, p = 0.0002), double labeled surface (dLS/BS, p = 0.029), and bone formation rate (BFR/BS, p = 0.037) suggested poorer bone forming capacity in our patients. No evidence of hyperparathyroid bone disease or osteomalacia was found. BV/TV was below the reference range (14.2%) in 65.5% of cases; these patients had lower values for Tb.Th (p = 0.037) and Tb.N (p = 0.0003), greater Tb.Sp (p = 0.0002), a tendency to lower adjusted apposition rate (Aj.AR, p = 0.057), and had had less frequent intake of dairy products than those with normal BV/TV (p = 0.024). Furthermore, months since menarche correlated with histomorphometric variables BV/TV (r = 0.667, p = 0.009), Tb.Th (r = 0.745, p = 0.002), Tb.Sp (r = -0.549, p = 0.042), O.Th (r = 0.784, p = 0.0009), and Aj.AR (r = 0.549, p = 0.042). The correlation between Tb.Th and spinal bone mineral content (r = 0.656, p = 0.015) suggests that the reduced trabecular thickness reflected a generalized bone condition. A greater than normal proportion of patients had spinal bone mineral density values below -1 standard deviation (SD) of the mean (osteopenia) (p = 0.001). Patients tested for parathyroid hormone and 25-hydroxyvitamin D levels were found to have normal values. Parathyroid hormone correlated with Aj.AR (r = 0.661, p = 0.038) and serum phosphorus (r = -0.764, p = 0.010). We conclude that sexual immaturity and possibly past dietary calcium deficiency contributed to osteopenia, and that this, together with obesity, led to the development of more severe and more frequently bilateral SCFE in our patients than in reported series of black and white children.
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PMID:Bone disease in African children with slipped capital femoral epiphysis: histomorphometry of iliac crest biopsies. 951 18

Hormonal imbalance in puberty and biomechanical overload due to obesity have been implied in the still unknown cause of slipped capital femoral epiphysis (SCFE). Local mediators of growth hormone (GH) action, such as insulin-like growth factor I (IGF-I), play a crucial role in the development of the growth plate cartilage. Concentrations of IGF-I and its binding protein 3 (IGFBP-3) were measured in the serum of 19 SCFE children without endocrine disorders. Standing height and body weight were determined. The results were related to the bone age. Concentrations for IGF-I and IGFBP-3 were predominantly within the normal ranges for chronologic age and bone age. The correlation of IGF-I and IGFBP-3 serum levels was high. Standing height and body weight showed a tendency toward the higher percentile ranges. Ten of 19 patients were above the 97th percentile concerning their weight for height. Bone age did not differ significantly from chronologic age. Serum concentrations of IGF-I and IGFBP-3 provided no evidence of a disturbance of the somatotropic axis in SCFE children. Increased body weight associated with normal skeletal maturation implies a mechanical stress factor in the cause of SCFE in these children.
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PMID:Serum insulin-like growth factors IGF-I and IGFBP-3 in children with slipped capital femoral epiphysis. 1021 70

A 12-year-old boy showed mild dysmorphic features, late presentation of learning difficulties and behaviour problems, obesity, breast hypertrophy and bilateral slipped capital femoral epiphysis. His mother also has mild dysmorphic features, obesity, and a similar history of late presentation of learning difficulties and behaviour problems. Cytogenetic analysis demonstrated an inherited distal long arm deletion of one chromosome 4. The boy's karyotype was interpreted as 46,XY,del(4)(q32 q33)mat and the mother's karyotype as 46,XX,del(4)(q32 q33). This is the second report of an inherited distal 4q deletion and the first report of interstitial chromosome 4 deletion involving q32 q33 segments.
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PMID:A new inherited interstitial deletion of the distal long arm of chromosome 4. 1079 75

Three young people, a boy aged 15 years and two girls aged 9 years and 13 years, had already suffered groin pain and knee pain for many months. They exhibited an antalgic walk, diminished function of the hip and radiographic signs of a slipped capital femoral epiphysis (SCFE). The complaints disappeared following in situ fixation with one or more screws. Epiphysiolysis of the caput femoris through the growth plate is a disorder of the growing hip. It is the most prevalent hip disease in adolescents. Obese boys are the most commonly affected. The aetiology is not known. The later SCFE is diagnosed and treated, the greater the chance of premature coxarthrosis. Avascular necrosis and chondrolysis are complications that can arise as a result of the operation.
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PMID:[Pain and gait problems in 3 (almost) adolescents with a dislocated hip]. 1145 Jun

Slipped capital femoral epiphysis (SCFE) mainly occurs in pubertal children and is associated with delayed skeletal maturation, obesity, high growth velocity and tall stature. Furthermore, SCFE often coincides with endocrine disorders. This is the first report of a possible relationship between SCFE and GnRH agonist treatment: four patients developed SCFE during or shortly after treatment with GnRH agonists was stopped. We compared the clinical aspects of these patients with patients described in the literature who developed SCFE. Puberty started at the age of 3.3, 9.6, 0.0 and 5.6 years respectively. One patient developed sequential SCFE of both hips. SCFE occurred at the age of 11.9 (patient 1), 12.7 (patient 2), 14.3 (patient 2), 11.3 (patient 3) and 11.3 (patient 4) years. Of the five incidences of SCFE, one occurred during GnRH agonist treatment and four shortly after treatment was stopped. None of our patients met the typical criteria seen in SCFE and no 'regular' characteristics of patients with SCFE could be designated. Probably the hormonal changes during and shortly after treatment with GnRH agonists make the epiphysis more prone to slip. Considering our observations and by reviewing the literature, GnRH agonist treatment might present a risk factor for the occurrence of SCFE.
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PMID:Can GnRH-agonist treatment cause slipped capital femoral epiphysis? 1145 22

Progression of slip is apt to cause complications including osteonecrosis and osteoarthritis. Such complications result in a poor prognosis for the joint. Therefore, to diagnose slipped capital femoral epiphysis (SCFE) while it is still mild is important to avoid complications as well as to prevent further slippage. In Japan, as the number of obese patients increases, obesity seems to be involved in the onset of slip both biomechanically and endocrinologically. We need to take care of obese children as they comprise a reservoir for SCFE patients. For severe slip cases, treatment is difficult owing to significant deformity of the femoral head with or without such complications as osteonecrosis and osteoarthritis. Transtrochanteric anterior rotational osteotomy is a promising option for preventing further slippage as well as to improve the congruity of the joint.
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PMID:Slipped capital femoral epiphysis: etiology and treatment. 1504 54

Southwick's angles measured in the anteroposterior and Lauenstein frog-leg views have been used for planning surgical treatment of deformities caused by slipped capital femoral epiphysis (SCFE). Clinically established epiphysiolysis is associated with a decrease in anteroposterior angles and an increase in Lauenstein angles. Obesity is one of the factors involved in the development of SCFE, but its influence in Southwick's angles has not been previously described. Additionally, few reports describe normal values adjusted for sex and bone age. In this study, we determined Southwick's angles in normal control participants (n=70), in patients with obesity (n=31) and in patients with epiphysiolysis (n=33). The intra-observer variations were 1.7 and 23.3% for the anteroposterior and Lauenstein angles, respectively. No significant differences were detected in the control group when these individuals were compared according to sex or chronological age. Obese patients showed a significant increase in the anterposterior angle when compared with control individuals. The hip with epiphysiolysis presented a significant reduction in the anteroposterior angle and an increase in the Lauenstein angle, when the same was compared with the contralateral hip or with the control values. In patients with unilateral SCFE the Lauenstein angle of the normal hip was detected as increased, which was possibly related to the obesity associated with decreased insulin resistance presented by these patients. We conclude that the detection of risk for developing SCFE should include an expanded clinical and radiological profile characterized by pubertal males who present obesity associated with insulin resistance and an increase in Southwick's anteroposterior angle.
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PMID:Southwick's head-shaft angles: normal standards and abnormal values observed in obesity and in patients with epiphysiolysis. 1519 79

Prader-Willi syndrome (PWS) is characterized by hypotonia, obesity, hypogonadism, small hands and feet, and mental deficiency. Obesity and hypogonadism are also frequently associated with slipped capital femoral epiphysis (SCFE), suggesting that children with PWS might be at increased risk of developing SCFE. Members of the Prader-Willi Syndrome Association (U.S.A.) were surveyed regarding the history of orthopaedic problems in general and of SCFE in particular. A total of 565 (63%) responses were received. The prevalence of orthopaedic conditions included 47% with flat feet, 41% with scoliosis, 19% with knock knees, 10% with hip dysplasia, 9% with osteoporosis, 7% with patellofemoral instability, 3% with bowlegs, 2% each with clubfeet, nursemaid's elbow, or leg-length inequality, and one patient (0.2%) with SCFE. The results of the survey indicate that SCFE is uncommon in patients with PWS, but the prevalence of hip dysplasia is increased approximately 10-fold compared with the general population.
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PMID:High incidence of hip dysplasia but not slipped capital femoral epiphysis in patients with Prader-Willi syndrome. 1530 8


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