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Study: MRI effective in the diagnosis of persistent pediatric hip pain
British researchers said MRI can be useful for these young patients who lack a diagnosis.
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MANCHESTER — Children who experience constant, unexplained hip pain pose clinical challenges for orthopaedic surgeons, but one British team said MRI can be valuable in helping to make an accurate diagnosis.
Sunil Auplish, FRCS, and colleagues at the Nuffield Orthopaedic Centre in Oxford, England, “aimed to determine the value of MRI in children with hip pain, which remained unexplained following routine investigations,” including ultrasound examination, he said. Auplish presented the findings of the retrospective study at the British Orthopaedic Association Annual Congress 2007, here.
Retrospective review
The surgeons performed a retrospective review of clinical notes and MRI findings for all children who received an MRI scan for undiagnosed hip pain lasting more than 3 years. Fifty-five children underwent an MRI scan of their hips for unexplained hip pain — 29 boys and 26 girls, all with a mean age of 10.9 years.
The MRI study provided a positive diagnosis in 22 children (40%), including five cases of transient synovitis, according to their abstract.
“We also saw that three children were diagnosed with osteoid osteoma, two children had trochanteric bursitis, and two children had muscle trauma, including one who had adductor trauma and another child who had piriformis trauma,” he said.
Other conditions
Two children were diagnosed with nonspecific bone edema. The remaining eight children were diagnosed with Perthes’ disease, hemarthrosis, sacroiliac infection, synovitis secondary to juvenile idiopathic arthritis, ischio-pubic osteochondromata, acetabular dysplasia, Klippel-Trenaunay syndrome and resolution of an eosinophilic granuloma, respectively.
The other 33 children (60%) produced “normal” MRIs, Auplish said. None of the children discharged following a normal scan subsequently presented with hip disease.
Auplish said one drawback of the study is that it was a retrospective review and he hopes to convert his follow-up investigation into a prospective study.
For more information:
- Auplish S, Wilson D. The use of magnetic resonance imaging in the diagnosis of persistent hip pain in children. Presented at the British Orthopaedic Association Annual Congress 2007. Sept. 25-28, 2007. Manchester.