Some centers routinely evaluate the shape and contours of the femoral neck by utilizing radial imaging or radial reconstructions. Additional research has shown that the zero-echo time pulse sequence offers excellent visualization of cortical bone on MRI without the need for contrast, and it has been shown to be an effective sequence for evaluating osseous hip morphology [72]. MRI can also be useful in detecting extra-articular impingements (ischiopelvic, ischiotrochanteric, subspinous, and femoropelvic) [45,46]. Although there is a paucity of supportive data, some surgeons may use both MRI and CT in order to define the soft tissues (labrum and articular cartilage) and the bone, respectively. Measurements can be performed on radiography, CT, and MRI [42-44,47,48]. Chronic Hip Pain Radiography Hip Additional Views For further evaluation of disorders such as dysplasia or FAI, specialized views such as the false profile or elongated femoral neck lateral (Dunn) views can provide more detailed evaluation of the anatomy of the femoral head and neck and the degree of acetabular coverage of the femoral head [47]. US Hip In general, US is limited in its use for evaluating osseous structures. However, there is limited literature that demonstrates that US can be used to evaluate osseous features of FAI such as the alpha-angle [73]. However, US is not able to adequately evaluate osseous abnormalities deep to the cortex. One of the advantages of US is its ability to dynamically evaluate for extra-articular soft tissue impingement. US is not as sensitive as MRI or CT arthrography for the detection of labral tears [17], but it can be useful for the detection and localization of paralabral cysts for aspiration and injection [39,41]. Variant 4: Chronic hip pain. Suspect labral tear. 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 for the workup of an acetabular labral tear in a patient with chronic hip pain.
Chronic Hip Pain PCAs. Some centers routinely evaluate the shape and contours of the femoral neck by utilizing radial imaging or radial reconstructions. Additional research has shown that the zero-echo time pulse sequence offers excellent visualization of cortical bone on MRI without the need for contrast, and it has been shown to be an effective sequence for evaluating osseous hip morphology [72]. MRI can also be useful in detecting extra-articular impingements (ischiopelvic, ischiotrochanteric, subspinous, and femoropelvic) [45,46]. Although there is a paucity of supportive data, some surgeons may use both MRI and CT in order to define the soft tissues (labrum and articular cartilage) and the bone, respectively. Measurements can be performed on radiography, CT, and MRI [42-44,47,48]. Chronic Hip Pain Radiography Hip Additional Views For further evaluation of disorders such as dysplasia or FAI, specialized views such as the false profile or elongated femoral neck lateral (Dunn) views can provide more detailed evaluation of the anatomy of the femoral head and neck and the degree of acetabular coverage of the femoral head [47]. US Hip In general, US is limited in its use for evaluating osseous structures. However, there is limited literature that demonstrates that US can be used to evaluate osseous features of FAI such as the alpha-angle [73]. However, US is not able to adequately evaluate osseous abnormalities deep to the cortex. One of the advantages of US is its ability to dynamically evaluate for extra-articular soft tissue impingement. US is not as sensitive as MRI or CT arthrography for the detection of labral tears [17], but it can be useful for the detection and localization of paralabral cysts for aspiration and injection [39,41]. Variant 4: Chronic hip pain. Suspect labral tear. 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 for the workup of an acetabular labral tear in a patient with chronic hip pain.