BC Children's Hospital.
Departments of Physical Therapy.
J Pediatr Orthop. 2022 Aug 1;42(7):e742-e746. doi: 10.1097/BPO.0000000000002183. Epub 2022 May 13.
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.
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.
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.
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.
对于脑瘫（CP）患儿的髋关节监测，测量迁移百分比（MP）是至关重要的。在加拿大不列颠哥伦比亚省，参加该省髋关节监测计划的儿童在该省的三级儿科医院或当地社区医院拍摄 X 光片。本研究旨在回顾髋关节监测中完成的影像学报告。
纳入了 2015 年 9 月至 2019 年 12 月期间参加该省髋关节监测计划的 960 名儿童的骨盆 X 光片。检索了由项目协调员测量的 MP 值和（如果存在）由医疗机构放射科医生测量的值。使用 Bland-Altman 图和组内相关系数来测量项目协调员和放射科医生之间 MP 值的一致性。当髋关节监测团队对提示转诊给儿科矫形外科医生的社区医疗机构完成的图像的放射学报告进行审查时，进一步审查了定性意见。
共审查了 1849 张 X 光片，其中 69.3%（1282 张）在儿科医院拍摄，30.7%（567 张）在 64 家不同的医院或诊所拍摄。有 20.6%（264/1282）的儿科医院拍摄的 X 光片和 3.0%（17/567）的社区医院拍摄的 X 光片报告了 MP。 Bland-Altman 图分析发现，项目协调员和所有放射科医生报告之间的 MP 平均差值为 1.2%（95%置信区间=0.6%-1.8%），组内相关系数为 0.88（95%置信区间=0.86-0.90）。有 47 张在社区医院拍摄的 X 光片在髋关节监测团队审查后转诊给儿科矫形外科医生。其中 11 份报告指出存在正常或无明显异常的发现。
为脑瘫患儿髋关节监测完成的影像学报告不足以发现髋关节移位。特别是在社区医院，MP 的报告非常罕见。如果要将放射学报告用于脑瘫患儿的髋关节监测，需要对放射科医生进行教育。
