Usefulness of Radial Contrast-Enhanced Computed Tomography for the Diagnosis of Acetabular Labrum Injury

A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral anatomy and function, the etiology of labral tears in hip dysplasia, and diagnostic assessment of labral tears, and we discuss treatment strategies for coexisting labral tears and hip dysplasia.

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“…CT arthrography is reliable in labral diagnostics, but it exposes the patient to high doses of radiation (Yamamoto et al 2007). …”

Section: Radiologymentioning

confidence: 99%

The role of the acetabular labrum in hip dysplasia

2013

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“…In patients with contraindications for MR imaging, computed tomographic (CT) arthrography with radial reconstructions can be performed for the evaluation of labral injuries, albeit sensitivity was slightly lower than that reported in similar MR investigations (23).…”

Section: Labrummentioning

confidence: 99%

New Developments in Hip Imaging

Sutter¹,

Zanetti²,

Pfirrmann³

2012

Radiology

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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.

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“…Disadvantages of MRA include limited availability and morbidity due to postprocedural pain [36]. CT arthrography provides an alternative [37], although it may be inferior to MRA [38].…”

Section: Diagnosis and Clinical Presentation Of Labral Tearsmentioning

confidence: 99%

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

Hauser

Orlofsky²

2013

TOREHJ

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Abstract:Background: Acetabular labral tear is a debilitating condition for which there are few effective non-surgical treatment options. A number of studies in humans and in animal models suggest that the labrum may have a capacity for spontaneous healing, and that therapies that seek to exploit and facilitate this process may be beneficial. Regenerative injection therapies have shown promise in the treatment of several musculoskeletal disorders, but have not previously been applied to labral tear. Methods:We present an initial case series of 19 patients with labral tear that were treated in our clinic with intra-articular injections of hypertonic dextrose. Patient-reported assessments were collected by questionnaire between 1 and 60 months post-treatment (mean = 12 months).Results: All patients reported improvements in pain relief and functionality. Patients reported complete relief of 54% of recorded symptoms. Improvements did not show dependence on the time between treatment and follow-up. No adverse events were reported. Conclusions:Regenerative injection therapy (prolotherapy) for acetabular labral tear appears to be a safe and potentially efficacious procedure that merits further investigation as a non-surgical option.

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Usefulness of Radial Contrast-Enhanced Computed Tomography for the Diagnosis of Acetabular Labrum Injury

Cited by 38 publications

References 15 publications

The role of the acetabular labrum in hip dysplasia

The role of the acetabular labrum in hip dysplasia

New Developments in Hip Imaging

Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study

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