Magnetic Resonance Imaging with Gadolinium Arthrography to Assess Acetabular Cartilage Delamination

Abstract

Recent reports have demonstrated magnetic resonance imaging (MRI) as a promising technique in detecting articular cartilage lesions of the hip joint. The purpose of our study was to evaluate the diagnostic performance of MRI with gadolinium arthrography in detecting acetabular cartilage delamination in patients with pre-arthritic hip pain. 46 patients (48 hips) underwent surgical dislocation of the hip. Mean age was 38.8 (range 17-56). There were 26 males and 20 females. All patients had Magnetic Resonance Imaging with gadolinium arthrography (MRA) before undergoing open hip surgery where the acetabular cartilage was inspected. Acetabular cartilage delamination on MRA was seen on sagittal images as a linear intra-articular filling defect of low signal intensity >1mm in thickness on T1 weighted images and surrounded by contrast. On MRA all hips had a labral tear confirmed at surgery. At surgery 30 hips had evidence of acetabular cartilage delamination, 4 hips had ulceration and 14 had no articular cartilage damage. The majority of labral tears and cartilage damage were located in the antero-superior quadrant. The sensitivity and specificity of MRA detection of cartilage delamination confirmed at surgery were 97% and 84%, respectively. The positive and negative predictive values of the MRA finding were 90% and 94%, respectively. The presence of the acetabular cartilage delamination represents an early stage of articular cartilage degeneration. When evaluating a young adult with hip pain, labral tears in association with cartilage delamination should be considered. MRA represents an effective diagnostic tool.

Nonarthritic Hip Joint Pain

“…84, 134 Currently, the most common imaging procedure used to confirm the diagnosis of intra-articular pathology, such as labral tears or chondral lesions is MRA. 77, 210 Contrast is injected into the hip joint to allow better visualization of the intra-articular structures. Compared to the gold standard of arthroscopic visual inspection, MRA has a sensitivity of 71% to 100% 18, 39, 59, 89 and a specificity of 44% to 71% 39, 89 in detecting a labral tear.…”

Examination of acetabular labral tear: a continued diagnostic challenge

“…63(NR)/33(NR)139 58 to 81/69 to 100140 50 to 79(NR)/77 to 84(NR)141 49 to 67(NR)/76 to 92(NR)142 97(82 to 99)/84(60 to 97)20…”

Efficacy of Intra-articular Steroid Injection in Patients with Femoroacetabular Impingement

“…3). However, magnetic resonance imaging is required to evaluate the labrum and articular cartilage [10]. …”