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
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 lead to prolonged time away from sport.
The differential diagnosis of anterior hip pain is broad and includes intra-articular and extra-articular pathology.
Additionally,
there are mimickers like sports hernia.
Causes of anterior hip pain in young athletes (+ frequency):
INTRA-ARTICULAR
- Femoroacetabular impingement (++++)
- Labral Tears (+++)
- Osteochondral lessions (++)
- Ligamentum teres injuries (++)
- Iliofemoral ligament injuries (+)
- Transient synovitis (++)
EXTRA-ARTICULAR
- Iliopsoas tendonitis and muscle injuries (++)
- Stress fracture (++)
- Adductor and pectineus strains or tendinopathy (++++)
- Osteonecrosis (+)
- Transient osteoporosis (+)
MIMIKERS
- Sports hernia (++)
- Osteitis pubis (++)
Conventional diagnosis was usually made by:
MRI
- Osteonecrosis-Transient osteoporosis
- Osteochondral lessions
- Ligamentum teres injuries
- Iliofemoral ligament injuries
- Transient synovitis
- Iliopsoas strains
- Osteitis pubis and adductor tendinopathy
- Stress fractures-bone marrow edema
MR ARTROGRAPHY
- Femoroacetabular impingement
- Labral Tears
- Ligamentum teres injuries
CT MULTISLICE
- Stress fracture
- Osteochondral lessions-loose bodies
ULTRASOUND
- Adductor and pectineus injuries
- Iliopsoas tendonitis (internal snapping hip)
- Sports hernia
• Regarding the intraarticular injuries labral tears and femoroacetabular impingement are by far the most frequent causes,
follow by ligament injuries.
• As for the extraarticular pathology adductor tendinopathy and muscle strains are the most usual conditions.
Iliopsoas pathology,
sports hernia and stress fractures come after.
• On the other hand,
osteonecrosis as well as transient osteoporosis are not so common in young athletes.