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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 7, 967-971.
doi: 10.1302/0301-620X.88B7.16564  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Urinary excretion of deoxypyridinoline in Perthes’ disease

A PROSPECTIVE, CONTROLLED COMPARATIVE STUDY IN 83 CHILDREN

B. Westhoff, MD, Senior Orthopaedic Surgeon1; R. Krauspe, MD, Professor, Head of Department1; A. E. Kalke, MD, Resident1; D. Hermsen, MD, Senior Clinical Pathologist2; B. Kowall, PhD, Assistant Professor3; R. Willers, PhD, Consultant for Statistics4; and U. Schneider, MD, Assistant Professor5

1 Department of Orthopaedics
2 Department of Clinical Chemistry
3 Department of Epidemiology and International Public Health, University of Bielefeld, Universitätsstrasse 25, D-33615 Bielefeld, Germany.
4 Department of Computational Statistics, Heinrich-Heine-University, Moorenstrasse 5, D-40225, Dusseldorf, Germany.
5 Arthro Nova Clinic, Seestrasse 19-21, D-83700 Rottach-Egern, Germany.

Correspondence should be sent to Dr B. Westhoff; e-mail: westhoff{at}med.uni-duesseldorf.de

Our aim was to investigate the relationship between urinary excretion of deoxypyridinoline (DPD) as a marker of bone resorption, and Perthes’ disease. There were 39 children with Perthes’ disease in the florid stage who collected first-morning urine samples at regular intervals of at least three months. The level of urinary DPD was analysed by chemiluminescence immunoassay and was correlated with the radiological stage of the disease as classified by Waldenström, and the severity of epiphyseal involvement according to the classification systems of Catterall and Herring. The urinary DPD levels of a group of 44 healthy children were used as a control.

The median urinary DPD/creatinine (CREA) ratio was significantly reduced (p < 0.0001) in the condensation stage and increased to slightly elevated values at the final stage (p = 0.05) when compared with that of the control group. Herring-C patients showed significantly lower median DPD/CREA ratios than Herring-B patients (p = 0.03). The significantly decreased median DPD/CREA ratio in early Perthes’ disease indicated a reduced bone turnover and supports the theory of a systemic aetiology. Urinary levels of DPD may therefore be used to monitor the course of Perthes’ disease.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General