Progressive bone and joint abnormalities of the spine and lower extremities in cerebral palsy

David S. Morrell, J. Michael Pearson, Donald D. Sauser

Research output: Contribution to journalArticlepeer-review

124 Scopus citations

Abstract

Bone and joint changes in cerebral palsy result from muscle spasticity and contracture. The spine and the joints of the lower extremity are most commonly affected. Scoliosis may progress rapidly and may continue after skeletal maturity. Increased thoracic kyphosis and lumbar lordosis, spondylolisthesis, spondylolysis, and pelvic obliquity may accompany the scoliosis. Progressive hip flexion and adduction lead to windswept deformity, increased femoral anteversion, apparent coxa valga, subluxation, deformity of the femoral head, hip dislocation, and formation of a pseudoacetabulum. In the knee, flexion contracture, patella alta, and patellar fragmentation are the most commonly seen abnormalities. Recurvatum deformity can also develop in the knee secondary to contracture of the rectus femoris muscle. Progressive equinovalgus and equinovarus of the foot and ankle are associated with rocker-bottom deformity and subluxation of the talonavicular joint. Early recognition of progressive deformity in patients with cerebral palsy allows timely treatment and prevention of irreversible change.

Original languageEnglish (US)
Pages (from-to)257-268
Number of pages12
JournalRadiographics
Volume22
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Cerebral palsy, 30.829, 40.829
  • Foot, abnormalities, 46.829
  • Hip, abnormalities, 442.829
  • Knee, abnormalities, 45.829
  • Spine, curvature, 30.86

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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