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Progressive Bone and Joint Abnormalities of the Spine and Lower Extremities in Cerebral Palsy¹

¹ From the Department of Radiology, Oregon Health Sciences University, Mail Code L340, 3181 SW Sam Jackson Park Rd, Portland, OR 97201. Recipient of a Certificate of Merit award for an education exhibit at the 2000 RSNA scientific assembly. Received March 15, 2001; revision requested May 29 and received July 13; accepted July 13. Address correspondence to J.M.P. (e-mail: pearsonm@ohsu.edu).

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.

© RSNA, 2002

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

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