Painful paediatric hip: frog-leg lateral view only!

Area of Science:

• Pediatric Radiology
• Diagnostic Imaging

Background:

• Standard practice for pediatric hip complaints involves anteroposterior (AP) and frog-leg lateral (FL) radiographs.
• This dual-view approach increases diagnostic yield but also doubles radiation exposure for children.

Purpose of the Study:

• To evaluate the diagnostic accuracy of a solitary FL radiograph compared to the combined AP and FL views for pediatric hip conditions.

Main Methods:

• Retrospective assessment of hip radiographs from 524 children (2-15 years) with acute hip pain.
• Two radiologists independently assessed solitary FL views, blinded to AP images.
• Cohen's kappa test was used to determine agreement between single FL view and combined AP/FL view assessments.

Main Results:

• Very high agreement (kappa = 0.989) was found between the assessment of the solitary FL view and the combination of AP and FL views.
• The diagnostic accuracy of the FL radiograph was equivalent to the standard two-view protocol.

Conclusions:

• A solitary frog-leg lateral (FL) radiograph is diagnostically sufficient for evaluating hip complaints in children.
• Adopting a single FL view can substantially reduce radiation exposure, costs, and imaging time.
• This simplified imaging protocol aligns with the principle of minimizing radiation exposure in pediatric patients.