Article

The pelvic radiograph in children with cerebral palsy (CP) can inform the
degree of hip displacement by calculation of the migration percentage. However,
concerns have arisen about the reliability of this measurement. The present study
examined the reliability of radiographic assessment of displacement and the
importance of positioning and reporting experience. Method Two pelvic
radiographs, taken at least an hour apart, were performed in 20 children (total
40 hips) in the standard position by a trained paediatric radiographer. Children
(13 males, seven females) were aged 30 months to 10 years with severe bilateral
spastic CP in Gross Motor Function Classification System levels IV (n=10) and V
(n=10). The migration percentage of each hip was measured on two occasions 3
months apart by two experienced radiologists independently. Comparisons of
migration percentage were made in three ways by (1) the same observer at the same
time, (2) the same observer 3 months apart, and (3) different observers 3 months
apart. Results Migration percentage (mean [SD]) was (1) 3.2% (3.5), (2) 3.3%
(3.2), and (3) 3.7% (3.8) respectively. Interpretation Reliable measures of
migration percentage can be obtained with correct positioning and if reported by
suitably experienced radiologists, making this a valid surveillance method.
Clinical decisions can be made taking into account an expected error in hip
displacement measurements.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS