The relationship between radiographic and anthropomorphic measurements of deformity of the thorax, hips, and pelvis in adults with cerebral palsy

Abstract

Non-ambulant adults with cerebral palsy (CP) are commonly affected by progressive secondary debilitating musculoskeletal issues, which may be clinically measured using the Goldsmith Indices of Body Symmetry (GIofBS). The primary aim of this study was to explore relationships between clinical outcomes and relevant radiographic measures in non-ambulant adults with CP. Thoracic shape and symmetry, pelvic orientation, and hip range were measured using the GIofBS. Radiographs of the pelvis and spine were reviewed. The Pearson correlation (r) or Pearson’s r was used to assess the relationships between clinical and radiographic measures. The positioning and readability of radiographic data in 30 non-ambulant adults with CP were variable. Minimal to no correlation between paired measures of radiographic and clinical data for trunk, pelvis, and hips were found, ranging from the lowest correlation of r(15) = –0.09, p = 0.620 (left migration percentage and hip range) to the highest of r(15) = –0.25, p = 0.200 (right hip morphology scale and hip range). The complex three-dimensional nature of asymmetries of the thorax, pelvis, and hips, measured clinically with the CIofBS, provides valuable, yet different, postural information to that obtained by radiographs. Inclusion of both radiographs and the GIofBS would enable a comprehensive lifespan assessment for postural management of adults with CP.