Radiograph evaluation in children with acute hip pain

Acute hip pain is relatively common in children. The etiology varies according to age and sex. Conventional radiography is commonly used to evaluate the painful hip. The views obtained depend on local departmental protocol, and there is no scientific basis for the choice of preferred projection. The authors' aim was to evaluate the role of anteroposterior (AP) and frog lateral (FL) radiographs in children younger than 14 years of age with hip pain to develop rational, evidence-based investigation guidelines. Four investigators retrospectively reviewed AP and FL radiographs of 96 children. The results were analyzed using the chi-square statistic. Overall results showed a reduction in sensitivity to about 70% and specificity to 90% when using a single view instead of combined views. These results indicate that despite the potential risks of increased radiation exposure with more than one view, combined AP and FL radiographs improve the diagnostic accuracy compared with single views alone. The authors believe that the additional radiation burden is therefore justified.