title: Tuberculosis of the hip in children: A retrospective analysis of 27 patients.
abstract: BACKGROUND
  We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them.
  
  
  METHODS
  We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria.
  
  
  RESULTS
  The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial "triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types.
  
  
  CONCLUSIONS
  The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Suri
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Indereshwar
authors.initials: I
authors.lastname: Verma
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Shashi Kant
authors.initials: SK
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
authors.forename: Abbas
authors.initials: A
authors.lastname: Shaharyar
keywords: Hip; osteoarticular; osteoarticular tuberculosis; pediatric; tuberculosis