The evaluation of hip joint pathologies in pediatric age group with MRI

Diagnosis of hip pathologies in the pediatric age group has difficulties. This study aimed to evaluate the hip diseases and prevalences detected by magnetic resonance imaging (MRI) in patients presenting with a preliminary diagnosis of hip pain. The MRI scans of pediatric patients who underwent hip MRI were re-evaluated retrospectively. Clinical and laboratory findings, pathology reports, operation and follow-up notes from the hospital information system, and MRI findings were re-evaluated as a whole and noted. It was examined whether there was a correlation between the prevalence of pathologies and the demographic data, such as age and gender. A total of 101 pediatric patients with hip pain were included in the study. The mean age was 12.29±3.35. Of these patients, 36 (35.6%) were female, and 65 (64.4%) were male. There was right hip involvement in 29 (28.7%), left hip in 47 (46.5%), and bilateral hip involvement in 25 (24.8%) patients. Legg-Calvé Perthes (LCP) disease was the most common final diagnosis seen significantly more frequently in males (p=0.016). Ischiofemoral impingement was significantly more common in girls (p=0.004). Avulsion fractures were significantly more commonly detected by patients over 10 years of age (p=0.019). Similarly, ischiofemoral impingement was more common in patients over 10 years of age (p=0.040). On the contrary, LCP disease was significantly more common in patients under 10 years of age (p<0.001). We observed that hip pathologies in children show significant differences between different age groups and genders. Because wrong and delayed diagnosis can cause irreversible joint destruction and early development of osteoarthritis, a fast and accurate diagnosis of hip pathologies in children is critical. Therefore, MRI plays a crucial role in the differential diagnosis of hip diseases, determining the correct treatment methods, and postoperative follow-up.

Keywords: Pediatric hip, pediatric hip pain, Legg-Calvé Perthes disease, femoral head epiphyseal slippage, ischiofemoral impingement, avulsion fracture, magnetic resonance imaging