There is limited literature supporting the use of indirect arthrography instead of direct MR arthrography for evaluating intra-articular disorders [34,61-63]. IV, rather than intra-articular, injection of contrast is faster and easier to perform and does not require image guidance, but indirect arthrography does not distend the joint capsule and results in less consistent enhancement of the joint space. The accuracy of indirect arthrography for evaluation of the acetabular labrum and articular cartilage remains uncertain. Because the literature supporting indirect arthrography is scant, it is a technique that is not often used clinically. MRI without IV contrast is useful for evaluating the labrum and articular cartilage in the setting of FAI and/or dysplasia. It can even be used for the detailed assessment of osseous anatomy, such as the shape and contour of the femoral neck. A noncontrast MRI can demonstrate findings of extra-articular impingement as well. At times, indirect arthrography may be performed following noncontrast image acquisition in order to obtain a complementary assessment of the hip and its synovium. MRI Hip Without IV Contrast FAI and dysplasia are associated with both intra- and extra-articular abnormalities, both osseous and soft tissue. The literature demonstrates that a noncontrast MRI is useful in the assessment of labral and cartilage lesions in the setting of hip impingement. Investigators have demonstrated success in detecting labral and articular cartilage lesions with high-resolution MRI of the hip at 1.5T without intra-articular contrast [58,68]. Additional literature has shown that high-resolution 3T MRI without IV contrast can further improve the visualization of the acetabular labrum and the articular cartilage of the femoral head and acetabulum [69,70]. Evaluation of cortical bone is more difficult with conventional MRI than it is with CT, but the use of isotropic MR sequences has been shown to be effective in the evaluation of FAI [71].
Chronic Hip Pain PCAs. There is limited literature supporting the use of indirect arthrography instead of direct MR arthrography for evaluating intra-articular disorders [34,61-63]. IV, rather than intra-articular, injection of contrast is faster and easier to perform and does not require image guidance, but indirect arthrography does not distend the joint capsule and results in less consistent enhancement of the joint space. The accuracy of indirect arthrography for evaluation of the acetabular labrum and articular cartilage remains uncertain. Because the literature supporting indirect arthrography is scant, it is a technique that is not often used clinically. MRI without IV contrast is useful for evaluating the labrum and articular cartilage in the setting of FAI and/or dysplasia. It can even be used for the detailed assessment of osseous anatomy, such as the shape and contour of the femoral neck. A noncontrast MRI can demonstrate findings of extra-articular impingement as well. At times, indirect arthrography may be performed following noncontrast image acquisition in order to obtain a complementary assessment of the hip and its synovium. MRI Hip Without IV Contrast FAI and dysplasia are associated with both intra- and extra-articular abnormalities, both osseous and soft tissue. The literature demonstrates that a noncontrast MRI is useful in the assessment of labral and cartilage lesions in the setting of hip impingement. Investigators have demonstrated success in detecting labral and articular cartilage lesions with high-resolution MRI of the hip at 1.5T without intra-articular contrast [58,68]. Additional literature has shown that high-resolution 3T MRI without IV contrast can further improve the visualization of the acetabular labrum and the articular cartilage of the femoral head and acetabulum [69,70]. Evaluation of cortical bone is more difficult with conventional MRI than it is with CT, but the use of isotropic MR sequences has been shown to be effective in the evaluation of FAI [71].