Cayla is having regular hip surveillance to monitor the developement of her hips. This is done twice a year by the Pediatric Rehabilitation Department at Princess Margaret Hospital (PMH) and monitors the indicators towards progressive hip displacement. Extreme tightness in the groin and hips can often lead to hip dislocation in children with cerebral palsy. It’s a severe problem, with a high risk of deformity and pain, resulting in problems with positioning, sitting, standing and walking.
Last week we met with a very nice physio therapist at PMH who examined Cayla’s movements and flexibility and send us off for an x-ray. The prime radiological measure for hip surveillance is migration percentage and this x-ray was compared to the one she had done six months ago. If I remember right her last x-ray showed a migration of nearly 30% which is quite a lot but great news is that this one showed a migration of 23% so it’s certainly going in the right direction.
The frequency of ongoing hip surveillance is determined by x-rays, GMFCS level and clinical assessment and as Cayla is level 2 her next check-up and x-ray will be in 12 months time instead of six which is great news!
Dr Colin Whitewood is the man who’s doing Cayla’s Botox injections at SJOG hospital in Subiaco. Him among others are talking about the importance of hip surveillance in this very informative short video.
Interestingly this physio therapist checked Cayla’s range on both feet and she was convinced that Cayla doesn’t need any Botox or casting on the right foot at all which is the opposite of what Dr Michael Chan (Lower limb & foot clinic) said a couple of weeks ago… The physio said that Cayla probably resisted a bit when he tried to stretch her foot and that you have to be a bit clever when it comes to kiddies and play with them to get them to relax and so on. Cayla will get some serial casting done on her left foot/calf in a few weeks time when the Botox peaks which is about 4-5 weeks after the injection.