Chicken or the egg?: The incidence of lower limb pathology and the association with individuals with increased body mass

Clinically, it is important to understand the long‐term mechanical effects of increased loadbearing on joints of the lower limb throughout ontogeny. This study looks at relationships among increased mass, femoral and proximal tibia dimensions, and the differences between individuals with and without lower limb skeletal pathology. A clinical control sample of juveniles categorized as having normal mass, both with and without skeletal pathology, was compared with juveniles considered clinically obese, also with and without skeletal pathology. Radiographic measurements of the femoral head, distal femur, and proximal tibia were taken. Measurements obtained from the images were corrected for parallax. Results indicate a high correlation between obese individuals and increased dimensions from femoral head and the medial knee, as well as greater frequencies of pathology. Furthermore, there is some indication that joint sizes may be adaptive and responding with skeletal pathology to increased weight gain in older children (10–17 yrs). This may indicate overcompensating in joint size growth among obese juveniles, most likely in response to high mechanical loads. The limitations of the data leave the timing of the onset of obesity unknown, however, and therefore the ontogeny of joint hypertrophy cannot yet be established. Grant Funding Source : N/A