New Developments in Hip Imaging

Abstract

The way the hip joint is imaged has changed in the past few years as a result of new discoveries in the biomechanics of the hip joint and the rapid developments in hip-preserving surgery. This review discusses technical advances made in the field of hip imaging, covering the roles of radiography, computed tomography, sonography and magnetic resonance (MR) imaging, as well as their limitations. New insight into anatomy and pathogenesis can be useful for the diagnosis of hip abnormalities and in treatment planning. While radiographs are the basis of any imaging of the hip, MR imaging is paramount in the evaluation and preoperative planning of patients suspected of having femoroacetabular impingement, especially when assessing geometrical deformities of the proximal femur. Damage patterns of labrum and cartilage in patients with femoroacetabular impingement are described, as well as new techniques of cartilage MR imaging that might allow the detection of cartilage degeneration before macroscopic defects are formed. Finally, new data on structural variants of the hip joint and pitfalls in imaging of the hip joint are reviewed.

Internal Derangements of Joints—Past, Present, and Future

“…67 Patients with FAI typically show either osseous overcoverage of the acetabulum (pincer-type FAI), osseous deformities of the femoral head-neck junction (camtype FAI), or both (mixed-type FAI). 68,69 Although some authors proposed to assess the pincer-type deformity with CT or MRI, it is best assessed with standard pelvic radiographs.…”

Regional Articular Cartilage Abnormalities of the Hip

“…The osseous prominence can be quantified using the alpha angle on oblique axial MR images; however, there is substantial overlap in the alpha angle measurements of healthy volunteers and patients with camtype deformities [74,75]. The anterosuperior segment has been recommended for this measurement because it discriminates between healthy subjects and subjects with FAI best [74,75].…”

Cam-type deformities: Concepts, criteria, and multidetector CT features

“…The exact cause of cam type deformity is unknown, as well as its actual prevalence, its actual usefulness as a FAI radiological marker, the optimal surgical indication, the natural history of non-operated FAI or the possible effectiveness of preventive surgery in asymptomatic patients with this deformity. 27,30,41,49,53 The idiopathic cam type deformity is an extension of the epiphysis towards the anterosuperior portion of the femoral neck. 22 In its most common manifestation, it is an osseous prominence lacking epiphyseal sphericity (cam) and a decrease of head---neck offset.…”