Radiographic abnormalities and clinical symptoms associated with patella alta in ambulatory children with cerebral
T A Topoleski1, C A Kurtz, D P Grogan
1Shriners Hospital for Children, Tampa, Florida 33612-9499, USA.
Insights
Spastic cerebral palsy in children often shows knee abnormalities like tibial tubercle elevation and patellar fragmentation on X-rays. These chronic findings are usually asymptomatic and require no treatment.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Radiology
Background:
- Spastic cerebral palsy (CP) frequently affects motor function, including lower extremities.
- Knee joint abnormalities are common in children with CP, impacting gait and development.
- Understanding the prevalence and nature of these abnormalities is crucial for patient management.
Purpose of the Study:
- To investigate the prevalence of radiographic knee abnormalities in skeletally immature children with spastic cerebral palsy.
- To identify specific common radiographic findings in the patella and proximal tibia.
- To correlate radiographic findings with clinical symptoms and assess the need for intervention.
Main Methods:
- A cohort of 117 skeletally immature, ambulatory children with spastic cerebral palsy was selected.
- Clinical examinations and lateral knee radiographs were performed for evaluation.
- Radiographs were analyzed for abnormalities in the patella and proximal tibia.
Main Results:
- Radiographic abnormalities were identified in 21% of affected knees (41 out of 193).
- The most frequent findings included tibial tubercle elevation (34 knees) and patellar pole fragmentation (7 knees).
- Patella alta was observed in nearly all participants; 32% of those with radiographic findings reported symptoms.
Conclusions:
- Radiographic knee abnormalities are common in children with spastic cerebral palsy.
- Tibial tubercle elevation and patellar fragmentation are prevalent findings.
- These chronic radiographic findings are typically asymptomatic and do not necessitate treatment.
Abstract:
One hundred seventeen randomly selected, skeletally immature, ambulatory children with spastic cerebral palsy were evaluated with clinical examination and lateral radiographs of the knee. Radiographic abnormalities within either the patella or the proximal tibia were present in 21% (41 knees) of the 193 affected knees. The most common radiographic findings were elevation of the tibial tubercle in 34 knees and fragmentation of one pole of the patella in seven knees. Clinical symptoms including pain, swelling, and tenderness were present in 32% of those children with radiographic findings (13 of 41 knees). Patella alta was seen in nearly all children in the study. The radiographic findings appeared to be chronic, were usually asymptomatic, and have required no treatment to date.
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