Hallazgos radiológicos en radiografías de cadera en un centro médico privado de la ciudad de La Paz
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Rev. bol. ped.
Abstract
Objetivos: estimar factores que influyen en la displasia del desarrollo de caderas. Diseño: estudio analítico observacional de casos y controles, en el cual se dio una encuesta a los padres de niños y niñas que acudieron al servicio de radiología, entre enero de 2005 y octubre de 2006, para realizar una radiografía de caderas. Se consideraron como casos a los pacientes con displasia y controles a los que no la presentaron. Se analizaron los datos en Epi Info 3.3.2. Lugar y contexto: centro médico "Unimed" de la ciudad de La Paz. Resultados: se evaluaron 142 pacientes de los cuales 30 (21.12%) tuvieron signos de displasia con ángulos acetabulares mayores a 30º. 5 Pacientes (3.5% del total y 16.6% de los con displasia) mostraron evidencia de luxación. El promedio de edad de pacientes con displasia fue de 3,3 meses. Existió antecedentes displasia en familiares de primer grado en 22.6% de los pacientes afectados; OR 1.49 (0.53 - 4.13) P 0.58. Pacientes con displasia y presentación podálica fueron 3.3% OR 1.25 (P 0.66) y con displasia obtenidos por cesárea 53.33%. OR 1.03 (0.43-2.48) P (0. 88). Los núcleos femorales estuvieron presentes en solo el 40% de los pacientes con displasia OR 3.73; P 0.0061 y ausentes en el 60% OR 0.27 (0.10- 0.76) P 0.0061. El núcleo estuvo fuera del cuadrante superior interno en 33.33% de los pacientes con displasia. Conclusión: se encontró una incidencia importante de displasia del desarrollo de caderas mediante los signos radiográficos en pacientes que acuden al centro médico Unimed. La presentación podálica y el nacimiento por cesárea no fueron factores de riesgo importantes en esta población. La presencia de núcleos femorales es un factor protector aunque su ausencia no tiene un valor predictivo en la patología.
Objectives: to consider factors that infl uence in the developmental dysplasia of the hips. Design: a survey was applied to the parents of children who went to radiology office, between January 2005 and October 2006, to realize a x-ray of hips. The patients with dysplasia were considered as a study cases and as control cases the ones who did not have dysphasia. The data in Epi Info 3.3.2 were analyzed. Place and context: medical center "Unimed" of the city of La Paz. Results: 142 patients were evaluated, 30 (21,12%) of them had signs of dysplasia with acetabular angles major to 30º. 5 Patients (3,5% of the total and 16,6% of the ones with dysplasia) showed luxation evidence. The average age of patients with dysplasia was of 3.3 months. There was an antecedent of dysplasia in relatives of first degree in 22.6% of the affected patients; OR 1,49 (0,53 - 4,13) P 0.58. Patients with dysplasia and podalic version were 3,3% OR 1,25 (P 0,66) and with dysplasia obtained by Cesarean 53,33%. OR 1,03 (0.43-2.48) P (0. 88). The femoral nuclei were present in only 40% of the patients with dysplasia OR 3.73; P 0,0061 and absentees in 60% OR 0,27 (0,10 - 0,76) P 0.0061. The nucleus was outside the internal superior quadrant in 33.33% of the patients with dysplasia. Conclusion: was an important incidence of dysplasia in the developmental of hips by means by radiology signs.The breech presentation and the birth by Cesarean section were not important factors of risk in this population. The presence of femoral nuclei is a protective factor although its absence does not have a predictive value in the pathology.
Objectives: to consider factors that infl uence in the developmental dysplasia of the hips. Design: a survey was applied to the parents of children who went to radiology office, between January 2005 and October 2006, to realize a x-ray of hips. The patients with dysplasia were considered as a study cases and as control cases the ones who did not have dysphasia. The data in Epi Info 3.3.2 were analyzed. Place and context: medical center "Unimed" of the city of La Paz. Results: 142 patients were evaluated, 30 (21,12%) of them had signs of dysplasia with acetabular angles major to 30º. 5 Patients (3,5% of the total and 16,6% of the ones with dysplasia) showed luxation evidence. The average age of patients with dysplasia was of 3.3 months. There was an antecedent of dysplasia in relatives of first degree in 22.6% of the affected patients; OR 1,49 (0,53 - 4,13) P 0.58. Patients with dysplasia and podalic version were 3,3% OR 1,25 (P 0,66) and with dysplasia obtained by Cesarean 53,33%. OR 1,03 (0.43-2.48) P (0. 88). The femoral nuclei were present in only 40% of the patients with dysplasia OR 3.73; P 0,0061 and absentees in 60% OR 0,27 (0,10 - 0,76) P 0.0061. The nucleus was outside the internal superior quadrant in 33.33% of the patients with dysplasia. Conclusion: was an important incidence of dysplasia in the developmental of hips by means by radiology signs.The breech presentation and the birth by Cesarean section were not important factors of risk in this population. The presence of femoral nuclei is a protective factor although its absence does not have a predictive value in the pathology.
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Vol. 46, No. 3