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Topic:

Adolescent Idiopathic Scoliosis

Issue:

Spine

Category:

Developmental

Title:

Can We Screen for Limb Length Discrepancy on Spinal Radiographs of Patients With Adolescent Idiopathic Scoliosis?

Author:

Mishra, Neeraj MS, MRCSEd; Lee, Nicole Kim Luan PhD; Loo, Liang Hui BSc (Hons); Lim, Kevin Boon Leong MD, FRCS(Eng), FRCSEd (Orth), MBA

Journal:

Journal of Pediatric Orthopaedics

Date:

November/December 2024

Reference:

44(10): p e894-e900, DOI: 10.1097/BPO.0000000000002773

Level Of Evidence:

III

# of Patients:

141

Study Type:

Retrospective study

Location:

Not specified (single-center study likely)

Summary:

This study investigates whether height differences in the iliac crests and femoral heads on spinal radiographs can be used as indirect methods for screening limb length discrepancy (LLD) in patients with adolescent idiopathic scoliosis (AIS). The study found a strong correlation between limb length discrepancy and femoral head height difference, suggesting these measurements can be used for screening and monitoring LLD in AIS patients.

Methods:

Retrospective review of whole-body PA and lateral erect radiographs of AIS patients. Direct limb length measurements were compared to femoral head height difference (FHHD) and iliac crest height difference (ICHD), using Pearson’s correlation, linear regression, and Bland–Altman plots.

Exclusions:

Patients with congenital, syndromic, and neuromuscular scoliosis were excluded.

Results:

A strong correlation (r=0.730, P<0.001) was found between LLD and FHHD, with a weaker correlation between LLD and ICHD (r=0.585, P<0.001). Linear regression predicted LLD of ≤10 mm based on FHHD of ≤11.5 mm or ICHD of ≤15.3 mm.

Conclusions:

FHHD and ICHD on PA radiographs can be used for screening and monitoring LLD in AIS patients, with FHHD being the preferred measurement. These measurements are quick and easy to perform, making them valuable for routine screening and monitoring in clinical settings.

Relevance:

Limitations:

Perspective:

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