To describe the main extra-articular causes of hip pain and outline MRIadvantages in the differential diagnosis.
To illustrate typical imaging features of various extra-articular pathologies,
primary or secondary bone tumours,
soft tissue tumors,
sacral/lumbar pathology and others.
Most of hip pathology present as pain.
However the source and location of hip pain can be quite difficult to assess.
Coxalgia can be produced from a multitude of sources.In fact there are several intra-articular causes for hip pain although it can originate apart from the hip joint itself.
MRI advancements improved and broadened the differential diagnosis of pain around the hip joint.
As far as treatment is concerned,
coxalgia can be adressed non-operatively,
arthroscopically or managed in open fashion having in mind the different...
Imaging findings OR Procedure details
EXTRA-ARTICULAR CAUSES OF COXALGIA
Plain film or CT
usually diagnostic in proper setting
CT may assist in differentiating remodeling from osteolysis with trabecular destruction caused by neoplastic disease
edema-like abnormalities or a fracture line (hypointense on both T1-weighted and fluid-sensitive sequences) at predilection sites
A.1 - Fatigue fractures features:
( Fig. 1 and Fig. 2 )
- result from abnormal stress to normal bone;
Hip pain is a frequent clinical problem and usually difficult toaccurately assess exclusively based on clinical parameters.
Coxalgia in adults may have different ethiologies which may relate to the hip joint per se or may be caused by extra-articular pathology.
Based on the aforementioned,
a clinical diagnostic evaluation should be made in order to perform appropriate imaging where standard radiographs represent the basis for most hip-related diagnoses and the next step commonly consists of MR imaging,
although sonography may compete with MRI in many soft...
1 - Laura W.
MR Imaging of Tumors and Tumor-Like Lesions of the Hip,
Magn Reson Imaging Clin N Am 13 (2005) 757–774;
2 - Jenny T.
MD; Jose ́ M.
Hamstring Injuries of the Hip,
Magn Reson Imaging Clin N Am 13 (2005) 677–690
3 - Donna G.
The painful hip: new concepts,
Skeletal Radiol (2006) 35: 352–370;
4 - Joel S.
Hospital da Luz,
UIME (MSK Imaging Unit),