MRI of the Hip: Important Injuries of the Adult Athlete

Abstract

Hip pain is a common problem in adult athletes and may be caused by a wide range of acute and chronic injuries, many of which lead to prolonged time away from sport. This article highlights the magnetic resonance imaging (MRI) findings of important hip injuries in adult athletes, including select osseous, impingement, intraarticular, and musculotendinous injuries. The most commonly affected athletes, clinical presentation, and MRI findings of each injury are reviewed with corresponding clinical pearls from the orthopedist's perspective.

Magnetic resonance imaging of the hip: anatomy and pathology

“…Articular hyaline cartilage is a complex combination of water, collagen, and proteoglycans, which help to distribute forces, absorb pressure, and enable gliding of the bony structures of the joint [ 4 ]. The entire femoral head is lined by articular hyaline cartilage, except for a small central depression known as the fovea capitis, where the ligamentum teres attaches [ 5 ].…”

“…The non-articular central depression of the acetabulum is known as the acetabular fossa, and is lined by synovium and filled with fibrofatty tissue/pulvinar [ 3 ]. A supra-acetabular fossa is a normal variant of the acetabular roof seen in up to 10% of the population, consisting of a pseudodefect covered by cartilage or fibrous tissue at the 12 o’clock position, and should not to be mistaken for an osteochondral defect [ 3 , 4 ] ( Figures 3 and 4 ). It is differentiated from a pathological lesion of the acetabulum by its smooth margins, absence of surrounding bone marrow oedema, and absence of cartilage irregularity.…”

Painful hip instability due to a partial tear of the iliofemoral ligament and labral injury following a cycling accident

“…1 The hip is the essential and central component of movement between the torso and lower extremities and is integral to proper performance in almost all sports. 2 Thus, hip pain in the athlete, whether recreational or elite, presents a critical challenge to performance. 2 Depending on the study and sport, the hip accounts for 3-18% of all sports-related injuries.…”

“…2 Thus, hip pain in the athlete, whether recreational or elite, presents a critical challenge to performance. 2 Depending on the study and sport, the hip accounts for 3-18% of all sports-related injuries. 2 Pain and dysfunction from athletic hip injuries cause significant morbidity, including the greatest time lost from sports compared to other lower extremity injuries.…”

“…2 Depending on the study and sport, the hip accounts for 3-18% of all sports-related injuries. 2 Pain and dysfunction from athletic hip injuries cause significant morbidity, including the greatest time lost from sports compared to other lower extremity injuries. 2 The etiology of mechanical hip pain can be either intraarticular or extra-articular, leading to an incredibly diverse list of differential diagnoses.…”