Keywords:
Diagnostic procedure, Ultrasound, Elastography, Conventional radiography, Musculoskeletal joint, Cerebral palsy
Authors:
H. Aslan, P. D. Analan; Adana/TR
DOI:
10.1594/essr2018/P-0020
Conclusion
In this study we aimed to assess the correlation between the MP and the stiffness of the hip muscles.
We showed a moderate positive correlation between MP and the stiffness of hip flexor muscles.
Until recently,
the correlation between the MP and the stiffness of the hip muscles in children with spastic CP had not been studied,
to our knowledge.
A baseline radiographic view of the pelvis was recommended at 12–18 months,
and follow-up of these patients at 6-month intervals has been suggested (8).
If hip migration continues to worsen,
injections of botulinum toxin and surgery may be needed.
The dislocation can be avoided,
by screening and preventive treatment of children with hips at risk (9).
Hip dislocation in CP is preventable,
by repeat radiographic and clinical examinations,
and preventive treatment in hips (4,8,10).
Elastography might be a complementary tool to assess the risk of hip displacement.
Spastic cerebral palsy causes excessive muscle tightness,
called spasticity.
This commonly affects the muscles in the back of the calf.
Previously Kwon et al.
showed the increased medial gastrocnemius muscle stiffness among children with CP when compared with the control group (11).Following-up the hip muscles stiffness may be a good predictive tool to evaluate the risk of hip dislocation.
Further studies measuring muscle stiffness may be helpful.
The most important limitation of the study was that double blinding of the children and examiner was not practicable due to the nature of spasticity and the elastography technique.
In conclusion,
we suggest that increased flexor and adductor muscle stiffness would be a potential high risk factor of hip dislocation in children with CP.
Combinations of these imaging modalities (X-Ray and SWE) in the follow-up might provide a more accurate assessment of the hip dislocation risk among patients with CP.