Role of magnetic resonance imaging as a diagnostic tool in evaluation of painful hip joint, and early detection of pathological changes, helpful to prognosticate and influence therapeutic decisions

Authors

  • Johny Prasad Bollipo Department of Radio Diagnosis, Katuri Medical College, Andhra Pradesh, India
  • Pasupuleti Bhimeswara Rao Department of Radio Diagnosis, Katuri Medical College, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20184679

Keywords:

Avascular necrosis of femoral head, Hip joint, Magnetic resonance imaging, Painful

Abstract

Background: Magnetic Resonance Imaging (MRI) is a well-established imaging technique, which are available at most larger hospitals today. Due to the combination of this high contrast and the fact that it is a non-ionizing radiation, MRI is often used for investigation of a large range of pathologies in almost all parts of the body. This study was performed to describe the MRI features in various types of lesions causing painful hip joint, as well as identify the common lesions seen in painful hip joint and to analyse the severity and extent of the underlying lesion in various conditions of hip joint pain, and early detection of pathological changes helpful to prognosticate and influence therapeutic decisions.

Methods: This descriptive study was done on 50 patients with complaints of hip joint pain were included into the study. Appropriate MRI sequences and multi-planar imaging performed for every patient.

Results: Out of the 50 patients included in the study, 74% of them were males who were predominantly affected with hip pain. The most common age group which was affected was 51-60 years (20%) and 21-30 years (20%). The most common pathology amongst the patients was Avascular necrosis of femoral head seen in 44% of the patients, osteoarthritis was seen in 54 patients, Tuberculosis in 5 patients, 2 had Perthe’s disease, joint effusion was observed in 6 patients.

Conclusions: MRI of the hip joint is an informative, diagnostic, non-invasive, rapid and accurate imaging modality for the assessment of hip pain and sufficient imaging modality for delineation of different hip joint pathology.

References

Shapiro L, Harish M, Hargreaves B, Staroswiecki E, Gold G. Advances in musculoskeletal MRI: technical considerations. J Magnetic Resonance Imaging. 2012 Oct;36(4):775-87.

Manaster BJ. Adult chronic hip pain: radiographic evaluation. Radiographics. 2000 Oct;20(suppl_1):S3-25.

Gabriel H, Fitzgerald SW, Myers MT, Donaldson JS, Poznanski AK. MR imaging of hip disorders. Radiographics. 1994 Jul;14(4):763-81.

Markisz JA, Knowles RJ, Altchek DW, Schneider RO, Whalen JP, Cahill PT. Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. Radiol. 1987 Mar;162(3):717-20.

Stoica Z, Dumitrescu D, Popescu M, Gheonea I, Gabor M, Bogdan N. Imaging of avascular necrosis of femoral head: familiar methods and newer trends. Current Health Sci J. 2009 Jan;35(1):23.

Potter HG, Black BR. New techniques in articular cartilage imaging. Clinics Sports Med. 2009 Jan 1;28(1):77-94.

Welsch GH, Trattnig S, Domayer S, Marlovits S, White LM, Mamisch TC. Multimodal approach in the use of clinical scoring, morphological MRI and biochemical T2-mapping and diffusion-weighted imaging in their ability to assess differences between cartilage repair tissue after microfracture therapy and matrix-associated autologous chondrocyte transplantation: a pilot study. Osteoarthritis Cartilage. 2009;17(9):1219-27.

Marlovits S, Singer P, Zeller P, Mandl I, Haller J, Trattnig S. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years. European J Radiol. 2006 Jan 1;57(1):16-23.

Sadro C. Current concepts in magnetic resonance imaging of the adult hip and pelvis. Semin Roentgenol. 2000;35(3):231-48.

Aldridge JM, Urbaniak JR. Avascular necrosis of the femoral head: etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop. 2008;33:327-2.

Takatori Y, Kokubo T, Ninomiya S. Avascular necrosis of the femoral head. JBJS. 2000;75:217-1.

Mitchell DG, Rao VM, Dalinka M, Spritzer CE, Axel L, Gefter W, et al. Hematopoietic and fatty bone marrow distribution in the normal and ischemic hip: new observations with 1.5-T MR imaging. Radiology. 1986 Oct;161(1):199-202.

Mitchell DG, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Steinberg ME, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology. 1987 Mar;162(3):709-15.

Glickstein MF, Burk Jr DL, Schiebler ML, Cohen EK, Dalinka MK, Steinberg ME, et al. Avascular necrosis versus other diseases of the hip: sensitivity of MR imaging. Radiology. 1988 Oct;169(1):213-5.

Huang ZG, Zhang XZ, Wang W, Hong W, Ren A. Avascular necrosis of the femoral head: correlation of imaging and pathological findings. Zhonghua yi xue za zhi. 2010 Oct;90(39):2745-9.

Hayashi D, Roemer FW, Felson DT. Magnetic resonance imaging of subchondral bone marrow lesions in association with osteoarthritis. Semin Arthritis Rheum. 2012;42:105-8.

Li KC, Higgs J, Aisen AM, Buckwalter KA, Martel W, McCune WJ. MRI in osteoarthritis of the hip: gradations of severity. Magnetic Resonance Imaging. 1988;6:229-36.

Horii M, Kubo T, Hirasawa Y. Radial MRI of the hip with moderate osteoarthritis. J Bone Joint Surgery. British volume. 2000 Apr;82(3):364-8.

Bos CF, Bloem JL, Bloem RM. Sequential magnetic resonance imaging in Perthes' disease. J Bone Joint Surgery. British volume. 1991 Mar;73(2):219-24.

Toby EB, Koman LA, Bechtold RE. Magnetic resonance imaging of pediatric hip disease. J Pediatr Orthoped. 1985;5(6):665-71.

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Published

2018-11-22

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Original Research Articles