In reference to this question, what are the guidelines for other GMFCS levels?
13. You are evaluating a 4-year-old child with spastic quadriplegic cerebral palsy, GMFCS level IV. The parents report that the child is having pain in his hips and they are very concerned about it. The family is new to the area and is currently only being followed by their new pediatrician. You make a referral to physical medicine and rehabilitation and orthopedics for the child. You explain to the family that it is important for the child’s hips to be examined by these specialists due to the pain he is currently experiencing. You discuss that ongoing hip surveillance is important since their child has a diagnosis of cerebral palsy and is at high risk for hip subluxation and/or dislocation. Based on the child’s age and GMFCS level, if his hips remain stable, what is the recommended hip surveillance schedule for this child?
a. One time a year until the child is skeletally mature
b. Two times a year for 12 months and then 1 time a year until the child is skeletally mature
c. Two times a year for 2 years and then 1 time a year until the child is skeletally mature
d. Two times a year until the child is skeletally mature
Per the hip surveillance guidelines for children with cerebral palsy established by the AACPDM, a child in GMFCS level IV should have hip x-rays and a clinical examination completed every 6 months for 24 months and then every 12 months until the child reaches skeletal maturity.
Below is the link to the guidelines. The link is also included in our reference list. We included this information because is it the most concise (and user friendly) resource for hip surveillance. There is a substantial body of literature on hip surveillance, however, this resource will be the most efficient review for exam purposes.