COSMIN database

Validity and reliability of radiological methods to assess proximal hip geometry in children with cerebral palsy: a systematic review

Pons, C., Remy-Neris, O., Medee, B., and Brochard, S.
AIM: The aim of this systematic review was to assess the current validity and reliability of radiological methods used to measure proximal hip geometry in children with cerebral palsy.

METHOD: A search was conducted using relevant keywords and inclusion/exclusion criteria of the MEDLINE, CINALH Plus, Embase, Web of Science, Academic Search Premier, The Cochrane Library, and PsychINFO databases.

RESULTS: The migration percentage using X-rays showed excellent reliability and concurrent validity with three-dimensional (3D) measurements from computed tomography (CT) scans. The acetabular index, measured using X-rays had good reliability but moderate concurrent validity with 3D CT measurements; 3D CT scan indexes had greater reliability. The measurement of the neck shaft angle using X-rays showed excellent concurrent validity with measurements from 3D CT scans and excellent reliability. Regarding femoral anteversion, one study found an excellent correlation between two-dimensional CT and clinical assessment and excellent reliability. Two others showed less evidence for the use of CT ultrasounds.

INTERPRETATION: Most of the X-ray-based measurements showed good to excellent metrological properties. More metrological evidence is needed for the assessment of femoral anteversion. Magnetic resonance imaging and ultrasound-based measurements have great potential although very little metrological evidence is available.
Dev Med Child Neurol
1469-8749 (Electronic)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Children (0-18)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
7 - Observations
9 - Laboratory tests
2D CT - Two dimensional Computed Tomography
3D CT - Three-dimensional Computed Tomography
Acetabular index
CR - Conventional Radiography
CT - Computed Tomography
Head-shaft angle
Hip migration percentage
Neck-shaft angle
Robin and Graham classification