US can also nicely demonstrate fluid collections around the hip, such as bursitis and paralabral cysts. Tendon pathology, such as tendinosis, tears, or snapping iliopsoas tendons can also be identified with US [38-41]. US may also be useful for the dynamic evaluation of the iliopsoas tendon, such as in snapping hip syndrome. Variant 3: Chronic hip pain. Suspect impingement or dysplasia. Radiographs negative or nondiagnostic. Next imaging study. Bone Scan Hip There is no relevant literature to support to the use of bone scan of the hip in the evaluation of suspected hip impingement. CT Arthrography Hip Pathology associated with femoracetabular impingement (FAI) may be both intra- and extra-articular. CT is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. CT arthrography has been shown to be sensitive for detection of acetabular labral tears [17], which may be associated with FAI. CT arthrography has also been shown to be more helpful in identifying chondral lesions [16] when compared to MRI. However, arthrography does not offer an advantage over noncontrast CT for the detection of extra-articular impingement (eg, ischiopelvic, ischiotrochanteric, subspinous, and femoropelvic). CT Hip With IV Contrast CT without IV contrast is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. However, IV contrast administration does not confer an additional advantage for evaluation of hip impingement. CT Hip Without and With IV Contrast Noncontrast CT is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. IV contrast administration is not warranted for evaluation of hip impingement. Fluoride PET/CT Skull Base to Mid-Thigh One study demonstrated the potential use of fluoride PET to demonstrate increased bone turnover in the setting of chronic hip pain and FAI [50].
Chronic Hip Pain PCAs. US can also nicely demonstrate fluid collections around the hip, such as bursitis and paralabral cysts. Tendon pathology, such as tendinosis, tears, or snapping iliopsoas tendons can also be identified with US [38-41]. US may also be useful for the dynamic evaluation of the iliopsoas tendon, such as in snapping hip syndrome. Variant 3: Chronic hip pain. Suspect impingement or dysplasia. Radiographs negative or nondiagnostic. Next imaging study. Bone Scan Hip There is no relevant literature to support to the use of bone scan of the hip in the evaluation of suspected hip impingement. CT Arthrography Hip Pathology associated with femoracetabular impingement (FAI) may be both intra- and extra-articular. CT is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. CT arthrography has been shown to be sensitive for detection of acetabular labral tears [17], which may be associated with FAI. CT arthrography has also been shown to be more helpful in identifying chondral lesions [16] when compared to MRI. However, arthrography does not offer an advantage over noncontrast CT for the detection of extra-articular impingement (eg, ischiopelvic, ischiotrochanteric, subspinous, and femoropelvic). CT Hip With IV Contrast CT without IV contrast is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. However, IV contrast administration does not confer an additional advantage for evaluation of hip impingement. CT Hip Without and With IV Contrast Noncontrast CT is often used for preoperative assessment of bony anatomy in the setting of FAI and hip dysplasia [42-44]. IV contrast administration is not warranted for evaluation of hip impingement. Fluoride PET/CT Skull Base to Mid-Thigh One study demonstrated the potential use of fluoride PET to demonstrate increased bone turnover in the setting of chronic hip pain and FAI [50].