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General Orthopaedics

THE USE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF PERSISTENT HIP PAIN IN CHILDREN

British Orthopaedic Association (BOA) 2007



Abstract

Aim

This study aims to determine the value of MRI in children with hip pain which remained unexplained following routine investigations including ultrasound examination.

Materials and methods

Retrospective review of clinical notes and MRI findings in all children who received and MRI scan for undiagnosed hip pain over three years.

Results

Fifty five children underwent an MRI scan of their hips for unexplained hip pain. 29 were male and 26 were female. The mean age was 10.9 years. The MR study provided a diagnosis in 22 children (40%), and was normal in 33 children (60%). Five cases were considered to be due to transient synovitis. Three children were diagnosed as osteoid osteoma. Two children were were found to have trochanteric bursitis. Two children were shown to have muscle trauma (one child with adductor trauma and one child with piriformis trauma). Two children were diagnosed with non-specific bone oedema. The remaining eight children were diagnosed with Perthes' disease, haemarthrosis, sacro-iliac infection, synovitis secondary to juvenile idiopathic arthritis, ischio-pubic osteochondrosis, acetabular dysplasia, Klippel-Trenaunay syndrome and resolution of an eosinophilic granuloma. None of the children discharged following a normal scan has subsequently presented with hip disease.

Conclusions

It is concluded that MRI is useful in the diagnosis of hip pain in children in whom routine investigation has not yielded an answer.