X-Ray Hip Examination in Patients with Cerebral Palsy
Background. X-ray indicators of the hip are important diagnostic factors of spastic hip dislocation in cerebral palsy. Correct X-ray examination has a decisive influence on the treatment strategy. Correct positioning parameters are well known, but their importance is often underestimated. This could be a trigger factor for further diagnostic and treatment errors. Materials and me-thods. The material was radiographs of the hip joints of 126 patients with cerebral palsy aged 2 to 18 years. Retrospective analysis of
X-ray indicators of the hip in patients with cerebral palsy was performed, they were divided into 2 groups: 1) indicators to determine the correct positioning (the distance between the pubic symphysis and the tip of the coccyx, symmetry of obturator foramen, crossing of the anterior and posterior edge of the acetabulum); 2) diagnostic indicators (migration index, caput-collum-diaphyseal angle).
Results. The technique of X-ray examination of the hip in patients with cerebral palsy includes the following steps: determination of the hip contracture using clinical examination; correct positioning of a patient during radiological examination, taking into account the contracture in the hip; evaluation of correct X-ray indicators (distance «pubis — tip of the coccyx», symmetry of obturator foramen, determination of the crossing of anterior and posterior acetabular edge); evaluation of the shift of diagnostic X-ray criteria of the femoral neck-shaft angle, migration index. Conclusions. Correct X-ray examination of the hip in cerebral palsy is very important for further dynamic observation of X-ray indicators of the hip and choosing the right treatment. The method includes four steps: determination of the contracture in the hip using clinical examination, correct positioning of a patients during X-ray examination, evaluation of X-ray indicators for correct positioning, evaluation of diagnostic X-ray indicators.
Full Text:PDF (Українська)
Consensus Statement on Hip Surveillancefor Children with Cerebral Palsy: Australian Standards of Care / M. Wynter, N. Gibson, M. Kentish [et al.] // Government of Western Australia, Department of health. — 2008. — 16 p.
Cornell M. The hip in cerebral palsy / M. Cornell // Dev. Med. Child. Neurol. — 1995. — V. 37 — P. 3-18.
Cooke P.H. Dislocation of the hip in cerebral palsy: natural history and predictability / P.H. Cooke, W.G. Cole, R.P. Carey // J. Bone Joint Surg. Br. — 1989. — V. 71. — P. 441-446.
Hip surveillance in children with cerebral palsy: Impact on the surgical management of spastic hip disease / F. Dobson, R.N. Boyd, J. Parrott [et al.] // J. Bone Joint Surg. Br. — 2002. — V. 84. — P. 720-726.
The ischial spine sign does pelvic tilt and rotation matter? / D. Kakaty, A. Fischer, H. Hosalkar [et al.] // Clin. Orthop. Relat. Res. — 2010. — № 468. — Р. 769-774.
Estimation of pelvic tilt on anteroposterior X-rays — a comparison of six parameters / M. Tannast, S.B. Murphy, F. Langlotz [et al.] // Skeletal Radiol. — 2005.
A systematic approach to the plain radiographic evaluation of the young adult hip / J. Clohisy, J. Carlisle, P. Beaulé [et al.] // J. Bone Joint Surg. Am. — 2008. — № 4. — Р. 47-66.
Wynter M., Gibson N., Kentish M. Consensus Statement on Hip Surveillancefor Children with Cerebral Palsy: Australian Standards of Care. Government of Western Australia, Department of health. 2008. — 16 p.
Cornell M. The hip in cerebral palsy // Dev. Med. Child. Neurol. — 1995. — V. 37. — Р. 3-18.
Cooke P.H., Cole W.G., Carey RP. Dislocation of the hip in cerebral palsy: natural history and predictability // J. Bone Joint Surg. Br. — 1989. — V. 71. — Р. 441-446.
Dobson F., Boyd R.N., Parrott J. Hip surveillance in children with cerebral palsy: Impact on the surgical management of spastic hip disease // J. Bone Joint Surg. Br. — 2002. — V. 84. — Р. 720-726.
Kakaty D.K., Fischer A.F., Hosalkar H.S., Siebenrock K.A., Tannast M. The Ischial Spine Sign: Does Pelvic Tilt and Rotation Matter? // Clin. Orthop. Relat. Res. — 2010 Mar. — № 468(3). — Р. 769-774. — doi: 10.1007/s11999-009-1021-5.
Tannast M., Murphy S.B., Langlotz F., Anderson S.E., Siebenrock KA. Estimation of pelvic tilt on anteroposterior X-rays — a comparison of six parameters // Skeletal Radiol. — 2006 Mar. — № 35(3). — Р. 149-55.
Clohisy J.C., Carlisle J.C., Beaulé P.E., Kim Y.-J., Trousdale R.T., Sierra R.J., Leunig M., Schoenecker P.L., Millis M.B. A Systematic Approach to the Plain Radiographic Evaluation of the Young Adult Hip // J. Bone Joint Surg. Am. — 2008 Nov 1. — № 90(Suppl. 4). — Р. 47-66. — doi: 10.2106/JBJS.H.00756.
Copyright (c) 2017 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020