Hip Anatomic Variants That May Mimic Abnormalities at MRI: Labral Variants

Nguyen, Mike S.; Kheyfits, Valeriy; Giordano, Brian D.; Dieudonne, Gregory; Monu, Johnny U. V.

doi:10.2214/ajr.12.9860

Cited by 41 publications

(26 citation statements)

References 26 publications

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“…The hyaline‐like acetabular cartilage, fibrocartilaginous labrum, and transition zone of fibrocartilage along the chondrolabral junction were all parallel in proportion and cellular make‐up between the caprine and human samples. As described in human labra, a physiologic cleft was also seen between the cartilage and labrum . Collagen typing within the acetabular cartilage and labrum revealed similar patterns between the caprine and human tissues.…”

Section: Discussionsupporting

confidence: 67%

Translational relevance of the goat as a preclinical model of the human labrum and chondrolabral junction—histological study

Rajappa

Nazal

Stelzer

et al. 2019

Journal Orthopaedic Research

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The purpose of this study was to evaluate the histologic features of the caprine labrum, with emphasis on the chondrolabral junction, with the goal of informing the feasibility of the goat as an animal model. The left hip joint of six adolescent Spanish goats (Capra pyrenaica) was harvested and subjected to anatomical and histological assessments. Human acetabular and femoral head samples, collected during total hip arthroplasty, served as comparison samples. The caprine labrum was found to consist of mostly type I collagen with uniform crimp, with an average crimp length of 20.8 µm. Upon histological assessment, acetabular articular chondrocytes were found to express substance-P, especially near or in the chondrolabral junction. And the majority of nonvascular cells expressed α-smooth muscle actin (SMA), with no notable elastin and laminin expression. Human labrum demonstrated similar staining patterns. Overall, the goat hip was found to be homologous to the human hip, demonstrating potential as a useful animal model for future studies. This is the first report of a crimped collagen structure in the labrum. Crimped type I collagen at the chondrolabral junction imparts an extensionrecovery property which allows for toleration of stress without permanent deformation, underlying the importance of its preservation during surgery. The high expression of substance-P reflects the degree to which the labrum is innervated. Finally, the expression of α-SMA with contractile characteristics could indicate the potential for chondrocyte (i.e., myochondrocytes) modeling of the extracellular matrix. Statement of Clinical Significance: Establishment of a large animal model and deeper knowledge of the histological composition of the hip joint will enhance our study of the acetabular labrum, including repair techniques.

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Section: Discussionsupporting

confidence: 67%

Translational relevance of the goat as a preclinical model of the human labrum and chondrolabral junction—histological study

Rajappa

Nazal

Stelzer

et al. 2019

Journal Orthopaedic Research

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“…Sublabral sulcus is an anatomical variant that may be present at any quadrant and mimics a tear on MR arthrography. Differentiation is difficult; however, in case of sulcus variant, contrast should not extend into the labrum substance or involve the entire thickness of its base [23,24].…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Arthrography, a valuable pre-operative imaging modality in femoro-acetabular impingement

El-Liethy

Zeitoun

Kamal

et al. 2019

Egypt J Radiol Nucl Med

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Background: The diagnostic accuracy of MR arthrography in preoperative assessment of labral tears and chondral abnormalities in femoroacetabular impingement patients. A non-randomized control study including 31 FAI patients (17 male and 14 females, mean age 31.9 years). All patients underwent MR arthrography after US-guided intra-articular contrast injection. Conventional and MR arthrography images were evaluated for bone abnormalities (including alpha angle and acetabular depth measurements), labral tears, and chondral abnormalities. The results were correlated to arthroscopy as the gold standard. Sensitivity, specificity, PPV, and NPV in the detection of labral tears and chondral abnormalities were statistically calculated. Results: The included FAI patients presented cam (mean age 30.4 years ± 6.8 years), pincer (mean age 33.6 years ± 9.8 years), and mixed (mean age 36.6 years ± 12.9 years) types with the predominance of cam type. Cam type predominated in the male, while pincer and mixed types predominated in female patients. MR arthrography detected 41 labral tears in 23 patients with 87.5%, 71.4%, 91.3%, and 62.5% sensitivity, specificity, PPV, and NPV, respectively, and detected chondral abnormalities in 13 patients with 66.7%, 92.3%, 92.3%, and 66.7% sensitivity, specificity, PPV, and NPV, respectively. Conclusion: MR arthrography is a valuable imaging modality in preoperative assessment of FAI patients. Besides identifying the type of impingement through alpha angle and acetabular depth measurements, it detects labral tears with high sensitivity and PPV. Although less sensitive in detection of chondral abnormalities, our results showed high specificity.

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“…Knowledge of anatomical variants that can mimic pathology is necessary to avoid misinterpretation, especially when applying the semiquantitative grading methods used in hip OA studies. Variants of the normal acetabular labrum are particularly relevant in this context, including changes in labral shape, size, intrinsic signal intensity and sublabral and perilabral sulci 54,55 , which can be difficult to differentiate from labral tears. A normal cleft at the junction of the transverse ligament and the anterior labrum may exist, which should not be mistaken for a labral tear 54,56 .…”

Section: Imaging Pitfalls and Anatomical Variantsmentioning

confidence: 99%

A narrative overview of the current status of MRI of the hip and its relevance for osteoarthritis research – what we know, what has changed and where are we going?

Crema

Watts

Guermazi

et al. 2017

Osteoarthritis and Cartilage

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Hip Anatomic Variants That May Mimic Abnormalities at MRI: Labral Variants

Abstract: The hip has multiple anatomic variants that can mimic abnormalities at hip MRI. The labrum has several anatomic variants that can be confused with true labral tears.

Cited by 41 publications

References 26 publications

Translational relevance of the goat as a preclinical model of the human labrum and chondrolabral junction—histological study

Translational relevance of the goat as a preclinical model of the human labrum and chondrolabral junction—histological study

Magnetic Resonance Arthrography, a valuable pre-operative imaging modality in femoro-acetabular impingement

A narrative overview of the current status of MRI of the hip and its relevance for osteoarthritis research – what we know, what has changed and where are we going?

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