Radiological Evaluation of the Hip of Patients with Congenital Zika Syndrome

Abstract

Introduction: Congenital Zika syndrome can generate microcephaly and spastic motor syndromes, limb deformities, and arthrogryposis. Hip dysplasia, associated with this syndrome, is frequent but poorly studied. Objective: To describe the radiographic alterations of the hip in patients with Congenital Zika Syndrome (CZS). Methods: Observational cross-sectional cohort study. We studied 25 patients with a serological diagnosis of CZS and a sample of 50 hips. Patients underwent evaluation, with lines and angles drawn on AP and P radiographs of the pelvis to assess the relationship between the femoral head and the acetabulum. The correlation was performed between radiographic changes of the hip in patients with SZC, gender, presence of arthrogryposis, spasticity, and microcephaly. Results: The mean age was 36 months (29-45 months), 15 patients were female (60%), with a predominance of blacks and browns (72%). The mean maternal age was 28 years (16-44 years), 11 (44%) had the disease before the 12th week of gestation, and all had clinical symptoms related to ZIKA virus infection. At birth, patients had an average head circumference of 26 cm (26-32 cm). Of the 50 hips evaluated in the study, 38 (76%) hips patients had orthopedic deformities, and 20 (40%) hips patients had arthrogryposis. In the radiographic changes of the hip, of the 50 hips, 12 (24%) hips were Tonnis grade I, 22 (44%) were subluxated (grade II), 9 (18%) were low dislocated (grade III), and 7 (14%) were high dislocated (grade IV). The RI was changed in 43 (86%) hips. ACD was valgus in 45 (90%) hips. ACEW was changed in 13 (26%) hips. The IA was changed in 18 (36%) of the evaluated hips. Conclusion: We found a high frequency of dysplastic changes in the hip in the patients of this study. So, we indicate radiological investigation of the hip in children with microcephaly and suspected CZS.