Evaluating Hip Labral Tears Using Magnetic Resonance Arthrography: A Prospective Study Comparing Hip Arthroscopy and Magnetic Resonance Arthrography Diagnosis

Chan, Yi Sheng; Lien, Li Chang; Hsu, Hui-Ling; Wan, Yung Liang; Lee, Mel S.S.; Hsu, Kuo-Yao; Shih, Chun–Hsiung

doi:10.1016/j.arthro.2005.07.007

Cited by 107 publications

(92 citation statements)

References 30 publications

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“…Compared to hip arthroscopy as gold standard, d-MRA is reported to have sensitivities of 63-100%, specificities of 44-100% and accuracy values of 65-96%. [50][51][52][53][54][55] For the detection of labral tears, the inter-observer reliability has been reported to be moderate. 50,56 With 2 dimensional in contrast to 3 dimensional MRI techniques, the assessment of thickness and orientation of the acetabular lesion was not optimal.…”

Section: Labrummentioning

confidence: 99%

Magnetic resonance imaging of hip joint cartilage and labrum

Zilkens¹,

Miese²,

Jäger³

et al. 2011

Orthop Rev (Pavia)

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Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of preexisting cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) might help to monitor the effect of surgical or nonsurgical procedures in the effort to halt or even reverse joint damage.

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Section: Labrummentioning

confidence: 99%

Magnetic resonance imaging of hip joint cartilage and labrum

Zilkens¹,

Miese²,

Jäger³

et al. 2011

Orthop Rev (Pavia)

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“…Further studies have assessed the usefulness of radial reformatted images to improve the sensitivity of labral tear detection. Chan et al [22] evaluated 16 patients with suspected labral tear by MR arthrography with radial reformatted images and used the arthroscopic findings as a reference; they demonstrated 100% sensitivity and 96% accuracy. However, more recent work by Yoon et al [23] found no difference in sensitivity in the detection of labral tears between radial reformats and standard MR arthrographic views.…”

Section: Discussionmentioning

confidence: 99%

The role of multidetector CT arthrography in the investigation of suspected intra-articular hip pathology

Christie-Large¹,

Tapp²,

Theivendran³

et al. 2010

BJR

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ABSTRACT. The aim of this study was to evaluate the role of multidetector CT (MDCT) arthrography in the diagnosis of intra-articular hip pathology. A retrospective review of 96 patients who had undergone CT hip arthrography was performed. Data regarding the presence of a labral tear, paralabral cyst, chondral loss, acetabular version, femoral morphology and fibrocystic change were collected. We detected 28 labral tears (24 anterior, 2 anterolateral, 1 lateral and 1 posterolateral). An abnormal labral-chondral transitional zone was seen in 9 patients and 4 patients had surface labral fraying. We identified three paralabral cysts. Acetabular cartilage loss was detected in 45 and femoral cartilage loss in 9 patients. An abnormal anterior femoral head and neck junction was present in 18 hips and fibrocystic change in 8. Acetabular retroversion was present in 11 hips. 63 sets of patient notes were reviewed, of which 49 were in-patients with abnormal MDCT arthrogram findings. Surgical correlation was available in 27 patients. There was a discrepancy between the findings of a labral tear in one patient (false negative, 90% sensitivity and 100% specificity) and the presence of acetabular cartilage loss (88% sensitivity and 100% specificity) and femoral cartilage loss (94% sensitivity and 100% specificity) in three patients. MDCT arthrography affords accurate detection of intra-articular hip pathology. The investigation of suspected intra-articular hip pathology is challenging. Arthroscopy represents the gold standard but is invasive, necessitates a general anaesthetic and is best reserved for patients in whom concomitant therapeutic intervention is to be undertaken. Much of the radiology literature has focused on the use of MR arthrography of the hip to detect labral and cartilage pathology [1][2][3][4][5]. A number of groups have also studied the role of non-contrast MRI in the detection of labral tears associated with femoroacetabular impingement and acetabular dysplasia [6][7][8][9]. Both non-contrast MRI and MR arthrography have limitations in terms of spatial resolution, which can make the detection of subtle labral and cartilage pathology challenging [4].Modern spiral multidetector CT (MDCT) technology allows submillimetre spatial resolution and has revitalised interest in the role of CT arthrography in the wrist, shoulder, knee, elbow and ankle [10][11][12][13][14][15][16][17]. There are few published data on the utility of this technique in the investigation of intra-articular hip pathology. Several studies have investigated the ability of MDCT arthrography to assess cartilage loss in the hip and have demonstrated that its accuracy is equal to, or can outperform, MR arthrography [18][19][20]. There are limited reports regarding the ability of MDCT arthrography to assess labral pathology [9]. The aim of this study was to evaluate the role of MDCT arthrography in the diagnosis of intraarticular hip pathology in a consecutive group of patients. Methods and materialsA retrospective review of 96 consecutive patients ...

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“…Magnetic resonance arthrography (MRA), in which MRI is enhanced by the intra-articular injection of gadolinium, has become the modality of choice for evaluation. The most recent studies find that MRA has a sensitivity of 93 -100 percent and an accuracy of 93-96 percent [30][31][32]. Metaanalysis supports the superior reliability of MRA to plain MRI, although variability and the use of small datasets were noted [33].…”

Section: Diagnosis and Clinical Presentation Of Labral Tearsmentioning

confidence: 90%

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

Hauser

Orlofsky²

2013

TOREHJ

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Abstract:Background: Acetabular labral tear is a debilitating condition for which there are few effective non-surgical treatment options. A number of studies in humans and in animal models suggest that the labrum may have a capacity for spontaneous healing, and that therapies that seek to exploit and facilitate this process may be beneficial. Regenerative injection therapies have shown promise in the treatment of several musculoskeletal disorders, but have not previously been applied to labral tear. Methods:We present an initial case series of 19 patients with labral tear that were treated in our clinic with intra-articular injections of hypertonic dextrose. Patient-reported assessments were collected by questionnaire between 1 and 60 months post-treatment (mean = 12 months).Results: All patients reported improvements in pain relief and functionality. Patients reported complete relief of 54% of recorded symptoms. Improvements did not show dependence on the time between treatment and follow-up. No adverse events were reported. Conclusions:Regenerative injection therapy (prolotherapy) for acetabular labral tear appears to be a safe and potentially efficacious procedure that merits further investigation as a non-surgical option.

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Evaluating Hip Labral Tears Using Magnetic Resonance Arthrography: A Prospective Study Comparing Hip Arthroscopy and Magnetic Resonance Arthrography Diagnosis

Cited by 107 publications

References 30 publications

Magnetic resonance imaging of hip joint cartilage and labrum

Magnetic resonance imaging of hip joint cartilage and labrum

The role of multidetector CT arthrography in the investigation of suspected intra-articular hip pathology

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

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