A pelvic radiograph is an excellent initial examination because it allows for evaluation of both hip joints on a single radiographic image, allowing for comparison of the ipsilateral and contralateral hips. Oftentimes, a pelvic radiograph may be obtained concurrently with additional dedicated radiograph(s) of the affected hip. Findings on pelvic radiographs can result in an imaging diagnosis such as osteoarthritis or may lead to more advanced workups of less common causes of chronic hip pain such as primary bone tumors. The results of the pelvic radiograph can help the clinician for the selection of additional imaging techniques and for comparison with studies such as MRI, CT, radionuclide bone scans, and fluoride PET [13-15]. Chronic Hip Pain US Hip There is no relevant literature to support the use of US hip in the initial evaluation of chronic hip pain. Variant 2: Chronic hip pain. Suspect noninfectious extra-articular abnormality, such as tendonitis or bursitis. Radiographs negative or nondiagnostic. Next imaging study. Bone Scan Hip There is no relevant literature to support the use of bone scan of the hip in the evaluation of extra-articular soft tissue abnormalities. CT Arthrography Hip The instillation of intra-articular contrast may elucidate periarticular soft tissue abnormalities such as labral or capsular pathology [16-18]. However, CT arthrography is limited for evaluating the extra-articular soft tissue pathology because of the inherent poor soft tissue contrast of CT. Within the limitation of CT; however, some extra- articular pathologic entities, such as a large, distended bursa may be evident on CT. Tendinous pathology is not particularly well depicted on CT. CT Hip With IV Contrast There is no relevant literature to support the use of CT hip with IV contrast in the evaluation of tendon or bursal pathology.
Chronic Hip Pain PCAs. A pelvic radiograph is an excellent initial examination because it allows for evaluation of both hip joints on a single radiographic image, allowing for comparison of the ipsilateral and contralateral hips. Oftentimes, a pelvic radiograph may be obtained concurrently with additional dedicated radiograph(s) of the affected hip. Findings on pelvic radiographs can result in an imaging diagnosis such as osteoarthritis or may lead to more advanced workups of less common causes of chronic hip pain such as primary bone tumors. The results of the pelvic radiograph can help the clinician for the selection of additional imaging techniques and for comparison with studies such as MRI, CT, radionuclide bone scans, and fluoride PET [13-15]. Chronic Hip Pain US Hip There is no relevant literature to support the use of US hip in the initial evaluation of chronic hip pain. Variant 2: Chronic hip pain. Suspect noninfectious extra-articular abnormality, such as tendonitis or bursitis. Radiographs negative or nondiagnostic. Next imaging study. Bone Scan Hip There is no relevant literature to support the use of bone scan of the hip in the evaluation of extra-articular soft tissue abnormalities. CT Arthrography Hip The instillation of intra-articular contrast may elucidate periarticular soft tissue abnormalities such as labral or capsular pathology [16-18]. However, CT arthrography is limited for evaluating the extra-articular soft tissue pathology because of the inherent poor soft tissue contrast of CT. Within the limitation of CT; however, some extra- articular pathologic entities, such as a large, distended bursa may be evident on CT. Tendinous pathology is not particularly well depicted on CT. CT Hip With IV Contrast There is no relevant literature to support the use of CT hip with IV contrast in the evaluation of tendon or bursal pathology.