Learning objectives
The differential diagnosis of hip pain is broad,
requiring a complete and broad knowledge of common and uncommon causes of coxalgia.
As suchthe authors provide a systematicapproach to intra-articular hip pathology.
In this review,
the main goals are to address the intra-articular causes of hip pain,including femoroacetabular impingement (FAI),
labral tears,
dysplasia and developmental abnormalities,
osteoarthritis,
avascular necrosis of femoral head (AVN),
inflammatory conditions,
deposition disease,
synovial abnormalities and tumors,
as well to discuss relevant imaging features and main differential diagnosis issues.
Background
Current imaging modalities allow a more precise evaluation of hip pain.
In recent years,
our understanding of the functional anatomy around the hip has improved.
In addition,
because of advancements in MRI,
the diagnosis of soft tissue causes of hip pain has also improved thus broadening the differential diagnosis.
We selected particular cases from our institution database between October 2007 and November of 2012.
ARTICULAR CAUSES OFHIP PAIN_________________
A.FEMOROACETABULAR IMPINGEMENT (FAI)
B.LABRAL PATHOLOGY
C.DYSPLASIAAND DEVELOPMENTAL ABNORMALITIES
D.OSTEOARTHRITIS
E.AVASCULAR NECROSIS OF FEMORAL HEAD
F.INFLAMMATORY CONDITIONS
Septic...
Imaging findings OR Procedure details
ARTICULAR CAUSES OF HIP PAIN
A.FEMOROACETABULAR IMPINGEMENT (FAI)
FAI is clinically characterized by a history of painful internal rotation and a positive impingement test.
During this test,
groin pain is provoked by a combined maneuver of 90° flexion,
adduction,
and internal rotation of the hip.
FAI refers to a conflict between the proximal femur and the acetabular rim and is a reason for premature osteoarthritis of the hip.
There are two different types of FAI (as well as the combined impingement type):
CAM
InCAM FAI...
Conclusion
Hip pain is a common clinical problem and often difficult to correctly assess only by clinical parameters.
Knowledge of different clinical entities and their imaging appearances is therefore essential for every radiologist (in general and specialized practice).
Take home messages:
Hip pain in adults may have many different causeswhich may directly relate to the hip joint,
to surrounding structures,
or even to non-related structures.
Therefore,
aclinical diagnosisshould be made in order to perform appropriate imaging.
Standard radiographsrepresent the basis for most hip-related diagnoses.
The next...
References
1.
Anderson K,
Strickland SM,
W arren R (2001) Hip and groin injuries in athletes.
Am J Sports Med 29(4): 521 533
2.
Christmas C,
Crespo CJ,
Franckowiak SC,
Bathon JM,
Bartlett SJ,
Andersen RE (2002) How common is hip pain among older adults? Results from the Third National Health and Nutrition Examination Survey .
J Fam Pract 51(4):345 348
3.
Lequesne MG,
Laredo JD (1998) The faux profil (oblique view) of the hip in the standing position.
Contribution to the evaluation of osteoarthritis of...
Personal Information
V.
V.Mascarenhas- Mascarenhas,
Vasco Vogado
Hospital da Luz,
UIME (MSK Imaging Unit),
Lisbon,Portugal
[email protected]
[email protected]
Fig.
87
References: Hospital da Luz - MSK Imaging Unit - Lisbon/PT