The hip surveillance program aims to identify hip problems in cerebral palsy patients at an early stage so that intervention can occur if required.
What does hip surveillance involve?
Hip surveillance involves X-rays of the hip joint and physical assessment. Children will be reviewed by a physiotherapist, who will assess function, leg length and range of movement as part of the process for determining each child’s individual risk factors. Each child will also be sent for pelvic X-rays as required.
Why does my child need hip surveillance?
Children with cerebral palsy have an increased risk of developing hip displacement, which may lead to dislocation of the femoral head out of the hip socket. This process usually occurs gradually and may go undetected without regular surveillance. Over time hip dislocation can lead to pain as well as difficulties with seating and posture. Children who have limited mobility (minimal or no ability to walk) are most at risk of hip displacement.
Up to 75 per cent of children with cerebral palsy who can’t walk may have some progressive hip displacement. This is thought to be predominantly related to the child’s mobility but may also be influenced by spasticity and contracture around the hip. Children who are more mobile have less risk of hip problems, however they will also require assessment.
Who should have hip surveillance?
All children with cerebral palsy or similar conditions. Children will be assessed for the frequency of surveillance they require.
What are the benefits?
Ongoing hip surveillance results in early detection of hip displacement. If identified and treated early, pain, dislocation, loss of function and deformity due to hip displacement may be prevented. Treatment options are greater with early intervention and management.
What happens when my child has a hip X-Ray?
Your child will be asked to lay still on their back on a table in a specific position with their legs straight for five to 10 minutes while the image is taken. The procedure is pain-free.
How often will my child need surveillance?
The timing of assessments is dependent on the type and severity of cerebral palsy, the results of any previous X-ray and age. This may be as often as every six months if your child’s individual risk of hip subluxation (dislocation) is assessed as high. Children will be monitored through clinics offered across the state. If there are any significant concerns, your child’s medical notes and X-rays will be discussed at an orthopaedic review or you will referred to an orthopaedic specialist.
What report will I receive and what does it mean?
A report summarising your child’s hip surveillance findings will be sent to you. You will see on the report that we present the measure of migration percentage from each X-ray. This measures the amount of the femoral head which is not covered by the acetabulum (socket). This is one of the key measures of any changes which would require closer monitoring or referral to an orthopaedic specialist. A low number for migration percentage is best, but change over time is also monitored.
Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.