It has been suggested that Perthes' disease is more prevalent in urban areas, and that the risk increases with deprivation. We present the findings of a preliminary analysis of Perthes' disease in Northern Ireland, which is shown to have one of the highest national annual rates of incidence in the world (11.6 per 100 000), Of the 313 children diagnosed over a seven-year period, 311 were allocated to the enumeration districts of the 1991 census, thus allowing the incidence to be calculated using both spatial and non-spatial aggregation. The cases were grouped according to the size of the settlement from highly urbanised to open countryside and by level of area deprivation. While the incidence of Perthes' disease was found to be associated with indicators of the level of deprivation for areas, there was no evidence to suggest that there was an increased risk in urban areas; the highest rate was found in the most deprived rural category.
Kealey, WDC., Moore, A., Cook, S., & Cosgrove, AP. (2000). Deprivation, urbanisation and Perthes' disease in Northern Ireland. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 82B(2), 167-171. https://doi.org/10.1302/0301-620X.82B2.10033