3d Ultrasound To Quantify Lateral Hip Displacement In Children With Cerebral Palsy: A Validation Study

Aim To assess the validity of a new index, lateral head coverage (LHC), for describing hip dysplasia in a population of children with cerebral palsy (CP). Method LHC is derived from 3D ultrasound assessment. Twenty-two children (15 males, seven females; age 4-15y) with CP undergoing routine hip surveillance were recruited prospectively for the study. Each participant had both a planar radiograph acquired as part of their routine care and a 3D ultrasound assessment within 2 months. Reimer's migration percentage (RMP) and LHC were measured by the same assessor, and the correlation between them calculated using Pearson's correlation coefficient. The repeatability of LHC was investigated with three assessors, analysing each of 10 images three times. Inter- and intra-assessor variation was quantified using intraclass correlation coefficients. Results LHC was strongly correlated with RMP (Spearman's rank correlation coefficient=-0.86,p<0.001). LHC had similar inter-assessor reliability to that reported for RMP (intraclass correlation coefficient=0.97 and intra-assessor intraclass correlation coefficient=0.98). Interpretation This is an initial validation of the use of 3D ultrasound in monitoring hip development in children with CP. LHC is comparable with RMP in estimating hip dysplasia with similar levels of reliability that are reported for RMP.