The Hip of Children with Congenital Zika Syndrome: A Prospective Observational Study
Jakeline Oliveira da Fonseca1, Renata Artimos de Oliveira Vianna2, Fabiana Rabe Carvalho2
1Orthopedic Service, Antônio Pedro University Hospital, Fluminense Federal University, Rio de Janeiro, Brazil.
Insights
Congenital Zika syndrome (CZS) can cause hip displacement in infants. Regular pelvic X-rays are crucial for monitoring hip deformities in children with CZS.
Area of Science:
- Pediatrics
- Orthopedics
- Infectious Diseases
Background:
- Congenital Zika syndrome (CZS) is a condition affecting infants born to mothers infected with the Zika virus during pregnancy.
- Hip joint deformities are a potential complication of CZS, requiring careful monitoring.
Purpose of the Study:
- To evaluate the clinical and radiographic features of hip joint deformities in children with CZS.
- To track the progression of these hip deformities during the first three years of life.
Main Methods:
- A prospective observational study involving 30 children with CZS.
- Regular orthopedic clinical examinations (every 3 months) and biannual pelvic radiographs were performed.
- The percentage of migration was used to measure hip displacement.
Main Results:
- During follow-up, 66.7% of children were diagnosed with hip displacement or dislocation.
- Spasticity and ophthalmologic abnormalities were significantly associated with hip dislocation.
- Hip displacement occurred more frequently on the right side (43.3%) than the left (30%).
Conclusions:
- Pelvic radiographic follow-up is essential for diagnosing and monitoring hip joint deformities in children with CZS.
- Integrating radiographic findings with physical examinations improves the management of CZS-related hip issues.
Objective:
To assess the clinical and radiographic characteristics of hip joint deformities in children with congenital Zika syndrome (CZS), and the evolution of hip joint deformities in affected infants for the first 3 years of life.
Study Design:
This prospective observational study evaluated orthopedic clinical examinations performed every 3 months to assess hip flexion and extension, lateral and medial rotation, and abduction and adduction, as well as lower limb muscle length and tone. The biannual radiograph comprised anteroposterior panoramic pelvic radiographs with the lower limbs in extension. Percentage of migration was used as a radiographic study tool to measure and evaluate linear hip displacement.
Results:
From November 2018 to March 2020, we followed 30 children with CZS, of whom 15 (50%) had normal pelvic radiographs on admission; 5 (33.3%) developed hip displacement by the second radiograph examination. During follow-up radiographic examinations, 20 of the 30 children (66.7%) were diagnosed with hip displacement and/or dislocation of at least 1 side, and 10 of the 30 (33.3%) remained normal. Among 30 affected patients, 13 (43.3%) had hip displacement on the right side and 9 (30%) on the left side. Logistic regression analysis revealed that spasticity (P = .0033; OR, 15.9) and ophthalmologic abnormalities (P = .0163; OR, 16.9) were associated with hip dislocation during follow-up.
Conclusions:
Pelvic radiographic follow-up for all children with CZS will complement physical examination, diagnosis, and monitoring for hip joint deformities.
