Imaging pathway of child with hip pain and limping

Dr. Sukumar Ramasamy; Dr. Gopinathan Kathirvelu; Dr. Amarnath Chellathurai; Dr. Sivakumar Kannappan

Volume : VIII, Issue : II, February - 2019

Imaging pathway of child with hip pain and limping

Dr. Sukumar Ramasamy, Dr. Gopinathan Kathirvelu, Dr. Amarnath Chellathurai, Dr. Sivakumar Kannappan

Abstract :

Objective : Hip pain and limping remained one of the major causes of children presenting to casualty , which if not diagnosed leads to permanent morbidity and mortality. The purpose of this study is to determine the best imaging pathway for particular hip pathology among children aged between newborn to 15 years. Materials and methods: This is a prospective observational study involving 67 children in our institute .Children of age group from newborn to 15 years(Table 1) ,presenting with complaints of hip pain , limping with /without swelling ,during a period of 3 years were selected for this study from January 2015-December 2017 . Statistical analysis done by Chi-Square test. Mode of investigations done for these children are USG ,X RAY,MRI depending on the age and symptoms . Results : The most common cause in age group less than 1 year is Developmental Dysplasia of the Hip . Ultrasonogram is found to be most sensitive if presentation is less than 6 months compared to X-RAY ,MRI . Septic and inflammatory arthritis is most common in 1-5 years age group ,Ultrasonogram is sensitive but MRI is more specific . The most common cause in age group 5-10 years is toxic synovitis ,perthes disease although X RAY is sensitive , MRI is specific., Slipped Capital Femoral Epiphysis,perthes, Idiopathic Chondrolysis of Hip is common in 10-15 years , MRI is more specific .MRI is superior to USG ,X RAY in diagnosing other causes of hip pathology. Conclusion: Different imaging modality can be used appropriately depending up on the age and symptom of the child and the imaging pathway as defined.