Type:
Educational Exhibit
Keywords:
Musculoskeletal bone, Musculoskeletal system, Anatomy, CT, MR, Arthrography, Acute, Arthritides, Developmental disease
Authors:
V. Mascarenhas, F. Morais, P. D. Afonso, A. Guerra, H. M. R. Marques, A. M. Gaspar; Lisbon/PT
DOI:
10.1594/ecr2013/C-2096
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 causes which may directly relate to the hip joint,
to surrounding structures,
or even to non-related structures.
- Therefore,
a clinical diagnosis should be made in order to perform appropriate imaging.
- Standard radiographs represent the basis for most hip-related diagnoses.
- The next step commonly consists of standard MR imaging or MR arthrography,
although sonography may compete with MR imaging in many soft tissue-related abnormalities.
- A single MR imaging protocol is not sufficient for demonstration of all possible abnormalities of the hip.
- The ancient bilateral imaging protocols using body or body array coils are no longer adequate considering the detailed analysis required by orthopedic surgeons.
- Although there remain some indications for bilateral examinations,
most protocols should aim at optimal imaging of one hip,
using dedicated coils and minimal field of view and slice thickness.
- For evaluation of the labrum and articular cartilage direct arthrography is indicated.
- In the case of an inflammatory condition or a tumor,
intravenous injection of gadolinium-containing contrast is indicated.
Table 1: General indications for diferent Imaging Studies
References: Hospital da Luz - MSK Imaging Unit - Lisbon/PT