Background: Measurement of migration percentage (MP) is fundamental to successful hip surveillance for children with cerebral palsy (CP). In British Columbia, Canada, children enrolled in the province’s hip surveillance program get radiographs at the province’s tertiary care pediatric hospital or their local community hospital. This study aimed to review the radiology reporting of images completed as part of hip surveillance. Methods: Pelvis radiographs completed between September 2015 and December 2019 of 960 children enrolled in the province’s hip surveillance program were included. MP values measured by the program coordinator and corresponding value measured by the facility’s radiologist, when present, were retrieved. Agreement in MP between the program coordinator and the radiologist was measured using Bland-Altman plots and intraclass correlation coefficients. Radiology reports for images completed at community facilities that prompted a referral to a pediatric orthopaedic surgeon, when reviewed by the hip surveillance team, were further reviewed for qualitative comments. Results: In total, 1849 radiographs were reviewed with 69.3% (1282) completed at the pediatric hospital and 30.7% (567) at 64 different hospitals or clinics. MP was reported for 20.6% (264/1282) of radiographs completed at the pediatric hospital and 3.0% (17/567) of the radiographs completed at community hospitals. Bland-Altman plot analyses found a MP mean difference of 1.2% (95% confidence interval=0.6%-1.8%) between the program coordinator and all radiologist reports with an intraclass correlation coefficient of 0.88 (95% confidence interval=0.86-0.90). There were 47 radiographs completed at community hospitals that resulted in a referral to a pediatric orthopaedic surgeon after review by the hip surveillance team. Eleven of these reports stated normal or unremarkable findings. Conclusions: Radiologic reporting of images completed for hip surveillance for children with CP was inadequate to allow for the detection of hip displacement. Reporting of MP was rare, particularly in community hospitals. If radiology reporting will be utilized for hip surveillance in children with CP, education of radiologists is required.
Cerebral palsy (CP) is an umbrella term used to describe all non-progressive disorders of movement and posture attributed to disturbances that occurred in the developing fetal and infant brain. 1 This includes all non-progressive disturbances occurring in the prenatal, perinatal, and postnatal period, up to age 2 years. 1 Diagnosis is based on clinical signs and symptoms, medical history, and neuroimaging; it is not defined by the underlying cause of the condition. 2 Possible etiologies of CP include, but are not limited to, preterm birth, congenital brain malformations, infections, intraventricular hemorrhage, and genetic abnormalities. 3 Frequently, the etiology of a child's CP is unknown. 4 A diagnosis of CP is often the first step for families to access CP-specific resources. The minimum age at which a valid and reliable diagnosis of CP can be given is controversial. 5 Traditionally, CP has been diagnosed between 12 and 24 months. 1,2,6 Recent evidence has suggested that this diagnosis can be accurately made before 6 months of age. 2 Delaying diagnosis may negatively impact developmental progress, access to services, such as hip surveillance and psychological support for parents, and prevention of secondary complications. 2,7,8 To avoid delay, an interim clinical diagnosis of high risk of CP is recommended until a diagnosis is confirmed. 2 Hip surveillance is now considered standard of care for children with CP. 9 Established surveillance programs allow for early identification of hip displacement and optimally timed orthopaedic intervention to prevent hip
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.