Why is hip surveillance important in CP, and what does it typically involve?

• A. To diagnose scoliosis.
• B. To measure cognitive development.
• C. To detect hip subluxation/dislocation early; involves serial radiographs and monitoring by GMFCS level to guide intervention.
• D. To monitor hand function.

Answer: (C)

In cerebral palsy, the hip is at risk for subluxation or dislocation because abnormal muscle forces and growth patterns can pull the femoral head out of the acetabulum over time. Hip surveillance targets catching that displacement early, before Pain, functional decline, or needs for major surgery develop. By using serial radiographs to track how the hip sits in the socket and by tailoring the monitoring intensity to the child’s GMFCS level, clinicians can decide when to intervene and what kind of intervention is most appropriate. The imaging usually involves periodic AP pelvis radiographs to measure how far the femoral head has migrated (migration percentage) and to watch for changes as the child grows. Higher GMFCS levels typically prompt more frequent imaging because they carry greater risk of progressive hip displacement. If the hip begins to migrate, the plan may shift from ongoing PT and positioning to more proactive measures—ranging from targeted therapies and bracing to surgical options aimed at stabilizing the hip and preserving joint function. The aim is early detection and a risk-guided plan to keep the hip in a stable position, minimize pain, and support sitting, standing, and mobility.