Quantitative Evaluation of Hip Muscle Atrophy in Patients with Unilateral Slipped Capital Femoral Epiphysis Based on Magnetic Resonance Imaging

Abstract

Hip muscle atrophy commonly occurs in patients with unilateral slipped capital femoral epiphysis (SCFE), its effect in patients with unilateral SCFE is worthy of further investigation. This study aimed to investigate the relationship between hip muscle cross-sectional area (M-CSA) and unilateral SCFE using magnetic resonance imaging. Overall, 32 unilateral SCFE patients (SCFE group) and 15 asymptomatic subjects (control group) were evaluated. All patients underwent magnetic resonance imaging and frog-leg lateral radiograph examinations. M-CSA and Southwick angle were evaluated to calculate the M-CSA ratio of the affected side over the healthy side (A/H) ratio in the SCFE group and the control group. Associations between the A/H ratio, Southwick angle, and the disease time course were investigated with Spearman correlation test. An independent sample t-test, one-way analysis of variance tests, and intraclass correlation coefficients were also applied. A/H ratios of the control group were significantly higher than those of the SCFE group (anterior muscles group: 1.09 ± 0.14 vs 0.86 ± 0.12, medial muscles group: 1.02 ± 0.15 vs 0.82 ± 0.18, posterior muscles group: 1.03 ± 0.07 vs 0.84 ± 0.11, all p < 0.01). A/H ratios of the medial and posterior muscle groups were significantly correlated with severity of SCFE (r = -0.504, p = 0.003, and r = -0.438, p = 0.012, respectively). Hip muscle atrophy is associated with SCFE severity in patients with unilateral SCFE. The A/H ratio can reflect the patients' prognosis and rehabilitation status. Maintenance of hip muscle morphology and function may be beneficial to clinical performance and prognosis of patients with unilateral SCFE.