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Imaging Parameters of Hip Dysplasia in Cerebral Palsy: A Systematic Review
Sitanshu Barik1, Aakash Jain2, Hawaibam Nongdamba2
1Department of Orthopaedics, All India Institute of Medical Sciences, Deoghar, Jharkhand India.
Insights
Hip dysplasia is common in children with cerebral palsy (CP). This review examines radiological parameters for detecting hip dysplasia, suggesting alternatives to the current gold standard for improved screening and planning in CP patients.
Area of Science:
- Pediatric Orthopedics
- Radiology
- Cerebral Palsy Research
Background:
- Cerebral Palsy (CP) is a leading cause of childhood physical disability.
- Hip displacement is the second most common musculoskeletal anomaly in CP patients.
- Radiological assessment is crucial for identifying and quantifying hip dysplasia in CP.
Purpose of the Study:
- To systematically review radiological indicators for hip dysplasia in children with cerebral palsy.
- To evaluate parameters beyond the current gold standard for hip surveillance in CP.
Main Methods:
- Comprehensive literature search across PubMed, Embase, and Google Scholar.
- Inclusion of studies utilizing radiological parameters for hip dysplasia detection in CP.
- Systematic review of 30 selected studies with evidence grading.
Main Results:
- X-ray was the most frequent imaging modality, followed by CT, ultrasonography, and arthrogram.
- Reproducibility of assessed parameters demonstrated good to excellent intraclass coefficients.
- Majority of included studies provided Level 3 evidence (16/30).
Conclusions:
- Alternative radiological parameters can effectively screen for hip dysplasia in CP.
- These parameters are valuable when standard views are limited by patient positioning or anatomical visibility.
- Further research is needed to fully explore the utility of these alternative parameters in clinical practice.
Background:
Cerebral Palsy is the leading cause of childhood physical disability globally. The motor disorders of CP are often associated with musculoskeletal anomalies, of which hip displacement is the second most common abnormality after abnormalities of foot and ankle. Various radiological parameters have been described in the literature which detects and quantifies hip dysplasia, with MP being the current gold standard. This study aims to review these radiological indicators of hip dysplasia in children with cerebral palsy from the published literature.
Methods:
A literature search using PubMed, Embase, and Google Scholar was done on 15th June 2021 focusing on surveillance of hip dysplasia in cerebral palsy. The studies to be included were to have used anyone or more radiological parameter for detection of hip dysplasia with the use of any of the radiological methods.
Results:
The initial search yielded 1184 results. After the screening of the abstracts and full texts, a final of 30 studies was included for this systematic review. The majority of the studies were graded as Level 3 evidence (16/30), followed by Level 2 studies (14/30). X-ray was the most common modality of detection of dysplasia followed by CT scan, ultrasonography, and arthrogram. The reproducibility of the various parameters shows good to excellent intraclass coefficients.
Conclusions:
Parameters other than MP can be used to screen hips in CP. This would be useful in patients in whom either the lateral acetabular edge is not discernible on a plain anteroposterior radiograph or there are issues in the positioning of the patient. Additional views and structures can be visualized which can lead to improved screening and planning. Further investigations are required to appreciate the full potential of these parameters and how they can be better utilized.
