Anterior hip pain in young athletes: a differential diagnosis challenge

Congress:

ECR 2018

Poster Number:

C-1986

Type:

Educational Exhibit

Keywords:

Musculoskeletal system, Musculoskeletal bone, Musculoskeletal joint, MR, Ultrasound, Ultrasound-Power Doppler, Arthrography, Athletic injuries, Trauma, Hernia

Authors:

P. Schvartzman¹, V. N. Alarcon¹, D. Salgado², C. A. Mariluis¹, D. C. Polillo¹, P. Quintian¹, E. Rossetto³, S. Centofante¹; ¹Buenos Aires/AR, ²Ciudad Autonoma de Buenos Aires/AR, ³Buenos Aires, Capital Federal/AR

DOI:

10.1594/ecr2018/C-1986

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1986

Fig. 1: 22 year old soccer player with left groing pain presenting popping and...

Fig. 2: ANTEROSUPERIOR LABRAL TEAR MR arthrography and original illustration

Fig. 3: TEAR OF ILIOFEMORAL LIGAMENT (MR image and correlate illustration)

Fig. 4: Complete tear of the descending fascicle of the iliofemoral ligament. Coronal,...

Learning objectives

To describe and illustrate the most frequent pathologies causing anterior hip pain in young athletes focusing in the different diagnosis considerations, including CT, MRI, ultrasonography and arthrography examples.

Background

We describe several types of hip injuries with diverse imaging modalities including original illustrations and positioning tips for US. Examples include: femoroacetabular impingement, hip labral tear, cartilaginous lesions, ligamentum teres and iliofemoral ligament injuries, iliopsoas bursitis, stress fracture, transient synovitis, osteonecrosis, adductor strain or tendinopathy, athletic pubalgia/sports hernia.

Findings and procedure details

50 patients were evaluated from May 2013 to June 2016. They were all recreational athletes and had groin pain confirmed by orthopedics. 64-slice CT scanner and 1.5 and 3 tesla MRI equipments were used. Ultrasound was performed by 12 MHz linear transducer for small parts. Arthrography was performed with fluoroscopic guidance targeting the lateral portion of the anterior recess. Hip pain is a well known limitation in young athletes and may be due to a wide range of acute and chronic injuries, many of which...

Conclusion

Groin pain is particularly frequent in young athletes, causing in many cases a well-known limitation in the return of playing. Their precise diagnosis could be considerable hard to reach being an extensive differential diagnosis and overlap in symptoms. Consequently, they require multiple radiological imaging methods in order to be accurate. The compound of multimodality image methods (include MR, ultrasound and arthrography) along with a thorough physicall examination help to determine a precise diagnosis in order to start the correct treatment in the shortest time as...

Personal information

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References

1. Byrd JWT. Hip arthroscopy: Surgical indications. Arthroscopy 2006;22:1260-1262. 2. Haene RA, Bradley M, Villar RN. Hip dysplasia and the torn acetabular labrum: An inexact relationship. J Bone Joint Surg Br 2007;89:1289-1292. 3. Burnett RSJ, DellaRoca GJ, Prather H, Curry M, Maloney WJ, Clohisy JC. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am 2006;88:1448-1457. 4. Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: Surgical technique and review of the literature. Arthroscopy 2005;21:1496-1504....