MR Arthrography versus conventional MRI in evaluation of labral and chondral lesions in different types of femoroacetabular impingement

Kaddah, Randa O.; Khalil, Mohsen Elsayed

doi:10.1016/j.ejrnm.2017.01.002

Cited by 3 publications

(5 citation statements)

References 25 publications

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“…[25] The gold standard diagnostic imaging modality for labral tears is magnetic resonance arthrography (MRA) or nonarthrographic HR MRI [9,31]. Studies have established that MRA, when infused with gadolinium, has a sensitivity of approximately 90% [32,33]. It retains an advantage over conventional magnetic resonance imaging (MRI, the sensitivity of 83%) for the diagnosis of acetabular and cartilage defects [34].…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Iliopsoas Tendinopathy and Labral Tears on High Resolution MRI, An Observational Study

Saad,

Chan,

Iqbal

et al. 2023

AML

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Introduction. Labral tears (LT) can present with hip or groin pain. Investigation of LT is typically with Magnetic Resonance Arthrography (MRA). The injection of contrast for MRA can lead to fluid signal intensity/oedema on fluid sensitive sequences within the iliopsoas muscle and tendon complex masking the diagnosis of iliopsoas tendinopathy, which may present with similar symptoms. The aim of this study was to identify the presence of iliopsoas oedema in young adult patients being investigated for LT.Material and methods. We performed a retrospective search of our radiology system for the word ‘labral tear’ in the reports of patients who had MRI between 2012 to 2018. Patients under the age of 40 years who underwent high resolution dedicated hip MRI were included in our study. From this database, we then used a keyword search ‘strain and (o)edema’ to identify cases of iliopsoas pathology and analysed the results. Results. We identified 1151 consecutive cases of high resolution hip MRI with a suspected labral tear. 503 patients under the age of 40 years were included in our study with the average age of 27 years. Of the 503 patients within our cohort, searching for the word ‘strain’ identified 48 (9.5%) cases. Of these, 26 (5.3%) patients had iliopsoas oedema with a labral tear. 22 (4.4%) patients had iliopsoas oedema without a labral tear. Conclusion. Our study shows that 4.4% of patients undergoing MRA have no labral tears but iliopsoas oedema. Patients should undergo MRI to exclude iliopsoas strains before MRA.

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Section: Discussionmentioning

confidence: 99%

The Incidence of Iliopsoas Tendinopathy and Labral Tears on High Resolution MRI, An Observational Study

Saad,

Chan,

Iqbal

et al. 2023

AML

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“…In this review, such abnormalities were confirmed using MRA with 90% sensitivity [ 24 ]. Recently, usage of other imaging modalities such as MRI and computed tomography (CT) has increased [ 28 ]. A 2017 study noted that sensitivity for detecting labral tears from conventional MRI was 70% compared with 95% for MRA, showing that MRA appears to be superior to MRI when assessing labral tears [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, usage of other imaging modalities such as MRI and computed tomography (CT) has increased [ 28 ]. A 2017 study noted that sensitivity for detecting labral tears from conventional MRI was 70% compared with 95% for MRA, showing that MRA appears to be superior to MRI when assessing labral tears [ 28 ]. Unlike MRI, CT provides improvements in detailing bony features of hip disorders [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…CT can also accurately control for patient positions when assessing femoral and acetabular version [ 29 ]. Although CT allows for a dynamic assessment of FAI, MRA and MRI techniques are typically used to avoid exposing patients to radiation, especially in younger populations [ 28 ]. Additionally, intra-articular hip injection is another technique used to diagnose FAI [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

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Historical analysis of the diagnosis and management of femoroacetabular impingement prior to the year 2000: a systematic review

Tejpal

Shanmugaraj

Kay

et al. 2020

Journal of Hip Preservation Surgery

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This systematic review aims to assess the diagnosis, indications and treatment of femoroacetabular impingement (FAI) prior to the year 2000 and to determine if historical concepts remain applicable today. PUBMED, MEDLINE and EMBASE were searched for literature evaluating the diagnosis/treatment of FAI prior to 2000. Cadaver/non-human, non-English and review studies were excluded. Quality assessment was performed using the Methodological Index for Non-Randomized Studies. Nine studies comprising 307 patients [315 hips; mean age of 32.6 ± 2.4 years (range, 12–58)] were included. Patients reported groin pain. Magnetic resonance arthrography (MRA; n = 76) and the anterior impingement test (AIT) (n = 88) were used to diagnose impingement. Surgical dislocation with a trochanteric flip osteotomy (n = 237) and Bernese periacetabular osteotomy (n = 40) were common treatments. Pain and range of motion improved for patients. Overall complication rate was 35% (n = 99), with heterotopic ossification (n = 79) most commonly reported. Prior to 2000, there was low quantity and quality of research on the diagnosis/management of FAI. Diagnostic evaluation was primarily through clinical examination (i.e. groin pain and AIT). MRA was occasionally used to detect labral degeneration; however, utilization of computed tomography (CT) and diagnostic injections were not reported. Surgical dislocation and osteotomies of the acetabulum yielded desirable short-term clinical outcomes with a moderate complication rate. No study reported using arthroscopy for FAI management prior to 2000. Clinicians today can learn from historical principles (i.e. clinical diagnosis of FAI, management with surgical correction of femoral head–neck offset) while applying novel techniques (i.e. CT, injections, arthroscopic surgical techniques and rehabilitation) to improve patient outcomes. Level of Evidence: IV (systematic review of III and IV evidence).

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“…It achieves a high sensitivity and specificity for labral tear identification of 95% and 92%, respectively, and of 94% and 91%, respectively, for chondral lesions. [36] Despite the success of invasive imaging, arthroscopy still retains a diagnostic role, albeit limited, especially in the case of undiagnosed hip and groin pain where all the investigations are equivocal, and it is the gold standard test for the identification of intra-articular pathology.…”

Section: Diagnosismentioning

confidence: 99%

History of hip arthroscopy

Shukla

Pettit

Kumar

et al. 2020

JASSM

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Hip arthroscopy is a minimally invasive therapeutic and diagnostic procedure appropriate for an evolving list of conditions. It is routinely used for the treatment of intra- and extra-articular pathology of the hip joint. The development of endoscopy paved the way for the development of arthroscopy. Hip arthroscopy was first described in 1931 by Michael Burman, and its widespread adoption was only achieved some 60 years later during the 1990s. Dr. Watanabe, from Japan, has been credited with the development of modern arthroscopy for his work in developing a practical arthroscope and advancement of both explorative arthroscopy and surgical arthroscopic techniques. More recently, the use of distraction proved as a significant step in the utility of hip arthroscopy and paved the way for future innovations in the procedure. The authors provide a brief overview of the history hip arthroscopy, relevant developments which have paved the way for this procedure and the current state of arthroscopy as a diagnostic and therapeutic procedure.

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MR Arthrography versus conventional MRI in evaluation of labral and chondral lesions in different types of femoroacetabular impingement

Cited by 3 publications

References 25 publications

The Incidence of Iliopsoas Tendinopathy and Labral Tears on High Resolution MRI, An Observational Study

The Incidence of Iliopsoas Tendinopathy and Labral Tears on High Resolution MRI, An Observational Study

Historical analysis of the diagnosis and management of femoroacetabular impingement prior to the year 2000: a systematic review

History of hip arthroscopy

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