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1. Blankenbaker DG, Tuite MJ. The painful hip: new concepts. Skeletal Radiol. 2006;35(6):352-370. Review/Other-Dx N/A To review the normal MR anatomy of the hip and the imaging findings of internal derangements, snapping hip, and femoral acetabular impingement; to describe the role of MR arthrography in evaluating the patient with suspected labral and articular cartilage abnormalities, as well as the pitfalls in interpretation; to review the causes of a snapping hip, and the role of sonography in evaluating and guiding treatment of the snapping iliopsoas tendon; and, to review the radiographic and MRI signs of femoroacetabular impingement (FAI), a cause of early degenerative joint disease and hip pain. No results stated in abstract. 4
2. Byrd JW. Evaluation of the hip: history and physical examination. N Am J Sports Phys Ther. 2007;2(4):231-240. Review/Other-Dx N/A To present a systematic examination process that outlines important components in each of the evaluation areas of history and physical examination (including inspection, measurements, symptom localization, muscle strength, and special tests). Using a thoughtful approach and methodical examination techniques, most hip joint problems can be detected. A proper treatment strategy can then be implemented including the role of conservative measures and interventional methods based on an accurate diagnosis. 4
3. Suarez JC, Ely EE, Mutnal AB, et al. Comprehensive approach to the evaluation of groin pain. J Am Acad Orthop Surg. 2013;21(9):558-570. Review/Other-Dx N/A To review a comprehensive approach to the evaluation of groin pain. A comprehensive history and physical examination can guide the evaluation of groin pain. 4
4. Saito J, Ohtori S, Kishida S, et al. Difficulty of diagnosing the origin of lower leg pain in patients with both lumbar spinal stenosis and hip joint osteoarthritis. Spine (Phila Pa 1976). 2012;37(25):2089-2093. Review/Other-Dx 420 patients To present the difficulty of diagnosing the origin of lower leg pain in patients with lumbar spinal stenosis and hip joint arthritis. Leg pain did not resolve after lumbar surgery in all patients. Conservative treatment was not effective from 6 to 12 months, so ultimately we performed ipsilateral total hip replacement for all patients and they became symptom-free. 4
5. Karrasch C, Lynch S. Practical approach to hip pain. Med Clin North Am. 2014;98(4):737-754, xi. Review/Other-Dx N/A To discuss practical approaches to hip pain. Hip pain is a common complaint among patients presenting to outpatient clinics. Stratifying patients based on age, acuity, and location of pain (extra-articular vs intra-articular) can help to aid in appropriate imaging and timely referral to an orthopedic surgeon. A thorough history and an organized physical examination combined with radiographs are usually sufficient to diagnose most hip complaints. If the diagnosis remains uncertain, magnetic resonance imaging, usually with intra-articular gadolinium, is the imaging modality of choice in diagnosing both intra-articular and extra-articular pathologies. 4
6. Alvarez C, Chicheportiche V, Lequesne M, Vicaut E, Laredo JD. Contribution of helical computed tomography to the evaluation of early hip osteoarthritis: a study in 18 patients. Joint Bone Spine. 2005;72(6):578-584. Observational-Dx 18 patients To show that helical computed tomography arthrograms (HCTA) with multiplanar reformations can document cartilage lesions and their characteristics in patients with suspected hip osteoarthritis and normal or inconclusive hip radiographs. We identified 18 patients with abnormal HCTA findings and a full set of imaging studies. Mean age was 47.8 years, and there were 14 women and four men. Acetabular cartilage lesions were found consistently; they were often deep and predominated in the anterosuperior region. A labral fissure was noted in 12 patients. The sagittal and coronal reformations proved more informative than the acquired transverse slices. Interobserver reproducibility was excellent for the HCTA diagnosis of cartilage lesions. 3
7. Perdikakis E, Karachalios T, Katonis P, Karantanas A. Comparison of MR-arthrography and MDCT-arthrography for detection of labral and articular cartilage hip pathology. Skeletal Radiol. 2011;40(11):1441-1447. Experimental-Dx 14 hips of 10 patients To compare the diagnostic ability of MR arthrography (MRa) and MDCT arthrography (CTa) in depicting surgically proven hip labral tears and articular cartilage degradation. Disagreement between the senior observer and the fellow observer was recorded in three cases of labral tearing with MRa and six with CTa. Disagreement was also found in four cases of cartilage erosion with both MRa and CTa. The percent sensitivity, specificity, accuracy, and positive predictive value for correctly assessing the labral tear were as follows for MRa/CTa, respectively: 100/15, 50/13, 90/14, and 90/13 (P < 0.05). The same values for cartilage assessment were 63/66, 33/40, 50/57 and 55/66 (P > 0.05). 2
8. Troelsen A, Mechlenburg I, Gelineck J, Bolvig L, Jacobsen S, Soballe K. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics? Acta Orthop. 2009;80(3):314-318. Experimental-Dx 18 patients To investigate the diagnostic validity of clinical tests and ultrasound as compared with MR arthrography. MR arthrography identified labral tears in 17 of the 18 hips. Ultrasound had a sensitivity of 94%, a positive predictive value of 94%, and was false negative in only 1 case compared to MR arthrography. The impingement test had the best diagnostic ability of the clinical tests, with a sensitivity of 59% and a specificity of 100%. The positive predictive value was 100% while the negative predictive value was 13%. 1
9. Jung JY, Kim GU, Lee HJ, Jang EC, Song IS, Ha YC. Diagnostic value of ultrasound and computed tomographic arthrography in diagnosing anterosuperior acetabular labral tears. Arthroscopy. 2013;29(11):1769-1776. Observational-Dx 36 hips; 34 patients To investigate the sensitivity, specificity, and accuracy of ultrasound as well as the computed tomography arthrography (CTA) findings and arthroscopic findings for the diagnosis of anterosuperior acetabular tear and correlated tear types using the Lage classification system on ultrasound and CTA compared with the arthroscopic findings. The sensitivity, specificity, and accuracy for sonographic detection of labral tear before injection/after injection were 58%/79%, 67%/58%, and 61%/72%, respectively, for observer 1 and 75%/92%, 25%/42%, and 58%/75%, respectively, for observer 2. The sensitivity, specificity, and accuracy for CTA detection of labral tears were 96%, 92%, and 94%, respectively, for observer 1 and 88%, 92%, and 89%, respectively, for observer 2. When the sonographic classification was compared with the arthroscopic findings of observer 1 and observer 2, the accuracy before injection/after injection was only 53%/67% and 58%/75%, respectively. The accuracy of morphologic classification of CTA and arthroscopic findings of observer 1 and observer 2 was 83% and 75%, respectively. Interobserver correlation before injection and at CTA was poor (kappa = 0.056) and moderate (kappa = 0.642), respectively. 2
10. Segall G, Delbeke D, Stabin MG, et al. SNM practice guideline for sodium 18F-fluoride PET/CT bone scans 1.0. J Nucl Med. 2010;51(11):1813-1820. Review/Other-Dx N/A To assist health care professionals in performing, interpreting, and reporting the results of PET/CT bone scans performed with 18F-fluoride. No results stated in abstract. 4
11. Taljanovic MS, Hunter TB, Fitzpatrick KA, Krupinski EA, Pope TL. Musculoskeletal magnetic resonance imaging: importance of radiography. Skeletal Radiol. 2003;32(7):403-411. Observational-Dx 1,030 MSK MRI studies were performed in 1,002 patients To determine the usefulness of radiography for interpretation of musculoskeletal (MSK) magnetic resonance imaging (MRI) studies. Radiographs were essential, very important or added information in 61-75% of all MSK MRI cases. Radiographs were judged as essential for reading of MRI studies more often for trauma, infection/inflammation and tumors than for degenerative and miscellaneous/normal diagnoses (chi(2)=60.95, df=16, P<0.0001). The clinical information was rated as "essential" or "useful" significantly more often than not (chi(2)=93.07, df=16, P<0.0001). The clinical and MRI diagnoses were the same or partially concordant significantly more often for tumors than for trauma, infection/inflammation and degenerative conditions, while in the miscellaneous/normal group they were different in 64% of cases. When the diagnoses were different, there were more instances in which radiographs were not available. 3
12. Kinds MB, Welsing PM, Vignon EP, et al. A systematic review of the association between radiographic and clinical osteoarthritis of hip and knee. Osteoarthritis Cartilage. 2011;19(7):768-778. Review/Other-Dx 45 studies To evaluate which methodological criteria are important to detect an association between radiographic and clinical OA of hip and knee. The literature search resulted in 39 studies describing an association between radiographic and clinical OA. The frequency of an association between radiographic and clinical OA outcome measures diminished when less quality criteria were fulfilled. Specifically the criterion for standardized outcome measures appeared important in the detection of an association. The association was not influenced by patient characteristics. Only four studies were identified that fulfilled all quality criteria and in these studies an association was found for the knee joint and an inconsistent association was found for the hip joint. 4
13. Clohisy JC, Carlisle JC, Beaule PE, et al. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90 Suppl 4:47-66. Review/Other-Dx N/A To summarize the recommendations of the ANCHOR (Academic Network for Conservational Hip Outcomes Research) study group regarding the most important aspects of radiographic technique and image interpretation to evaluate the symptomatic, skeletally mature hip. We have outlined a systematic approach to radiographic evaluation for the adult patient who has clinical signs and symptoms of hip dysfunction. It is our opinion that such a structured review of plain radiographs should help to facilitate a more reliable diagnostic and surgical decision-making process. However, it should be emphasized that an accurate diagnosis can only be obtained by interpreting radiographic findings in conjunction with a detailed history and physical examination. Advanced imaging studies, such as a magnetic resonance arthrogram and/or a computed tomography scan, can also be helpful to confirm a suspected diagnosis, identify mild impingement abnormalities, or act as a supplement in the treatment planning process. Nevertheless, many patients with prearthritic or early arthritic hip dysfunction have developmental dysplasia of the hip and/or femoroacetabular impingement that is readily apparent on properly made radiographs, making it important to be able to adequately and reliably recognize the structural features of these disorders. 4
14. Newberg AH, Newman JS. Imaging the painful hip. Clin Orthop Relat Res. 2003;(406):19-28. Review/Other-Dx N/A To review imaging of hip pain. By combining conventional MRI with capsular distention afforded by arthrography, MRA has become the imaging examination of choice for disorders of the acetabular labrum and for the evaluation of articular cartilage at the hip. 4
15. Jacobson JA, Bedi A, Sekiya JK, Blankenbaker DG. Evaluation of the painful athletic hip: imaging options and imaging-guided injections. [Review]. AJR Am J Roentgenol. 199(3):516-24, 2012 Sep. Review/Other-Dx N/A To review diagnostic imaging tests and injections that provide important information for clinical management of patients with sports-related hip pain. In the evaluation of sports-related hip symptoms, MR arthrography is often used to evaluate intraarticular pathology of the hip. The addition of short- and long-acting anesthetic agents with the MR arthrography injection adds additional information that can distinguish between symptomatic and asymptomatic imaging findings. Osseous abnormalities can be characterized with radiography, MRI, or CT. Ultrasound is important in the assessment of iliopsoas abnormalities, including tendon snapping, and to guide diagnostic anesthetic injection. 4
16. Peat G, Croft P, Hay E. Clinical assessment of the osteoarthritis patient. Best Pract Res Clin Rheumatol. 2001;15(4):527-544. Review/Other-Dx N/A To explore some of the practical implications of assessing the clinical syndrome of osteoarthritis as a chronic regional pain disorder and to examine some of the evidence available to judge its usefulness. The usefulness of assessing clinical osteoarthritis as a regional pain disorder is uncertain. Even if this were demonstrated, the concept of osteoarthritis as a structural disease should be retained as an integral part. 4
17. Chong T, Don DW, Kao MC, Wong D, Mitra R. The value of physical examination in the diagnosis of hip osteoarthritis. J Back Musculoskelet Rehabil. 2013;26(4):397-400. Observational-Dx 10 patients To compare the sensitivity of physical examination (internal rotation of the hip) with radiographs (using the Kellgren-Lawrence grading scale) in the diagnosis of clinically significant hip osteoarthritis. Based on Fisher's exact test, there was no association between severity of radiographic hip arthritis and pain relief with intra-articular anesthetic/steroid injection (p=0.45). Physical examination (provocative hip internal rotation) however was associated with a significant decrease in VAS pain score after intra-articular lidocaine and corticosteroid hip injection (p=0.022). 3
18. Menashe L, Hirko K, Losina E, et al. The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2012;20(1):13-21. Meta-analysis 16 studies; 1,220 patients To determine the diagnostic utility of MRI in OA through a meta-analysis of published studies. Of 20 relevant studies identified from the literature, 16 reported complete data and were included in the meta-analysis, with a total of 1220 patients (1071 with OA and 149 without). Overall sensitivity from pooling data of all the included studies was 61% [95% confidence interval (CI) 53-68], specificity was 82% (95% CI 77-87), PPV was 85% (95% CI 80-88), and NPV was 57% (95% CI 43-70). The ROC showed an AUC of 0.804. There was significant heterogeneity in the above parameters (I(2)>83%). With histology as the reference standard, sensitivity increased to 74% and specificity decreased to 76% compared with all reference standards combined. When arthroscopy was used as the reference standard, sensitivity increased to 69% and specificity to 93% compared with all reference standards combined. M
19. Xu L, Hayashi D, Guermazi A, et al. The diagnostic performance of radiography for detection of osteoarthritis-associated features compared with MRI in hip joints with chronic pain. Skeletal Radiol. 2013;42(10):1421-1428. Observational-Dx 44 patients To evaluate the diagnostic performance of radiography for the detection of MRI-detected osteoarthritis-associated features in various articular subregions of the hip joint. Compared with MRI, radiography provided high specificity (0.76-0.90) but variable sensitivity (0.44-0.78) for diffuse cartilage damage (using JSN as an indirect marker), femoral osteophytes, acetabular subchondral cysts and bone attrition of the femoral head, and a low specificity (0.42 and 0.58) for acetabular osteophytes. The AUC of radiography for detecting overall diffuse cartilage damage, marginal osteophytes, subchondral cysts and bone attrition was 0.76, 0.78, 0.67, and 0.82, respectively. 3
20. Westacott DJ, Minns JI, Foguet P. The diagnostic accuracy of magnetic resonance imaging and ultrasonography in gluteal tendon tears--a systematic review. Hip Int. 2011;21(6):637-645. Meta-analysis 7 studies To systematically review the peer-reviewed literature to establish the accuracy of magnetic resonance imaging and ultrasonography in the diagnosis of gluteal tendon tears in patients with persistent lateral hip pain or Greater Trochanteric Pain Syndrome (GTPS). MRI had sensitivity of 33-100%, specificity of 92-100%, positive predictive value of 71-100% and negative predictive value of 50%. False-positives were common. High signal located superior to the trochanter had a stronger association with tears. Ultrasonography had a sensitivity of 79-100% and positive predictive value of 95-100%. M
21. Bancroft LW, Peterson JJ, Kransdorf MJ. MR imaging of tumors and tumor-like lesions of the hip. Magn Reson Imaging Clin N Am. 2005;13(4):757-774. Review/Other-Dx N/A To review the role of MRI in the diagnosis of tumors and tumor-like lesions of the hip. Radiographs can depict the extent of disease; any characteristic calcifications; and osseous changes. MRI is now the preferred imaging modality of choice for evaluating osseous and soft-tissue masses of the hip by providing information for diagnosis and staging. The MRI signal characteristics and enhancement patterns of malignant and benign hip tumors permit specific diagnoses in some cases. Synovial-based tumor-like processes of the hip can be characterized by MR signal characteristics. MRI can also serve to exclude underlying osseous or soft-tissue tumors when radiographs display aggressive features of tumor-like processes. 4
22. Beltran J, Opsha O. MR imaging of the hip: osseous lesions. Magn Reson Imaging Clin N Am. 2005;13(4):665-676, vi. Review/Other-Dx N/A To discuss the imaging techniques and MRI manifestations of the osseous entities. Hip trauma and AVN are the most frequent indications for MRI. Other entities for which MRI has proven its usefulness include subchondral fractures, osteochondritis dissecans, transient osteoporosis, bone tumors, inflammatory and infectious processes, and a variety of bone marrow disorders. 4
23. Bencardino JT, Mellado JM. Hamstring injuries of the hip. Magn Reson Imaging Clin N Am. 2005;13(4):677-690, vi. Review/Other-Dx N/A To review role of MRI in the diagnosis of hamstring injuries of the hip. MRI may provide accurate information with regard to the site, grade, and prognosis of hamstring lesions. 4
24. Bordalo-Rodrigues M, Rosenberg ZS. MR imaging of the proximal rectus femoris musculotendinous unit. [Review] [19 refs]. Magn Reson Imaging Clin N Am. 13(4):717-25, 2005 Nov. Review/Other-Dx N/A To discuss the role of MRI in the diagnosis of the proximal rectus femoris musculotendinous unit. MRI is a helpful for diagnosing and grading proximal rectus femoris injuries. MRI is also valuable in predicting the length of recovery and rehabilitation time of musculotendinous strains and in presurgical planning when resection of a chronic hematoma, deep scar tissue, or a pseudocyst is contemplated. 4
25. Bredella MA, Stoller DW. MR imaging of femoroacetabular impingement. Magn Reson Imaging Clin N Am. 2005;13(4):653-664. Review/Other-Dx N/A To discuss the role of MRI in the diagnosis of FAI, a common cause of osteoarthritis in the hip. MRI and MR arthrography are accurate modalities to demonstrate acetabular labral disease and adjacent cartilage damage as well as the subchondral cysts and synovial herniation pits associated with impingement. MRI is also able to detect underlying subtle anatomic variations of the femoral head-neck junction and acetabulum associated with FAI. 4
26. Dillon JE, Connolly SA, Connolly LP, Kim YJ, Jaramillo D. MR imaging of congenital/developmental and acquired disorders of the pediatric hip and pelvis. Magn Reson Imaging Clin N Am. 2005;13(4):783-797. Review/Other-Dx N/A To review the role of MRI in the diagnosis of congenital/developmental and acquired disorders of the pediatric hip and pelvis. MRI provides an accurate method of evaluating the hip and pelvis. The soft-tissue resolution of MRI is superior to CT and is vital for purposes of imaging cartilage. 4
27. Dwek J, Pfirrmann C, Stanley A, Pathria M, Chung CB. MR imaging of the hip abductors: normal anatomy and commonly encountered pathology at the greater trochanter. Magn Reson Imaging Clin N Am. 2005;13(4):691-704, vii. Review/Other-Dx N/A To review the anatomy and pathologic findings of the osseous and soft-tissue anatomy of the greater trochanter. A detailed knowledge of anatomy is useful in MRI interpretation. 4
28. Koulouris G, Morrison WB. MR imaging of hip infection and inflammation. Magn Reson Imaging Clin N Am. 2005;13(4):743-755. Review/Other-Dx N/A To review MRI of hip infection and inflammation. MRI is the ideal modality for demonstrating the manifestations and sequelae of the infective and inflammatory conditions common to the hip. Combining clinical history and results and other imaging modalities yields a higher degree of specificity. 4
29. Malizos KN, Zibis AH, Dailiana Z, Hantes M, Karachalios T, Karantanas AH. MR imaging findings in transient osteoporosis of the hip. Eur J Radiol. 2004;50(3):238-244. Observational-Dx 42 patients To describe the MRI findings including perfusion imaging, in association with the course of acute bone marrow oedema syndrome, in a group of patients with acute hip pain and a final diagnosis of TOH. Osteopenia was present on plain radiographs in 87% of cases. The most common pattern of bone marrow oedema was extending to the femoral head and neck. Acetabulum was involved in 16.6%. In 22.6% the bone marrow oedema spared the subchondral region of the femoral head. There were 2 cases (4.7%) with subchondral changes. A joint effusion was noted in 33/42 patients. On perfusion imaging, a delayed peak enhancement was noted in 20 patients between 40 and 65 s after the first pass of contrast. No patient had any evidence of femoral head collapse or change in sphericity on follow-up MRI. None of the patients developed AVN in a time frame of 18 months from the onset of the acute hip pain. 3
30. Mellado JM, Bencardino JT. Morel-Lavallee lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am. 2005;13(4):775-782. Review/Other-Dx N/A To discuss the role of MRI in the diagnosis of Morel-Lavallee lesion. MRI is recommended in the assessment of Morel-Lavallee lesions in the hip region. 4
31. Nelson EN, Kassarjian A, Palmer WE. MR imaging of sports-related groin pain. [Review] [48 refs]. Magn Reson Imaging Clin N Am. 13(4):727-42, 2005 Nov. Review/Other-Dx N/A To discuss the role of MRI in the diagnosis of sports-related groin pain. MRI of the hip and pelvis can provide a prompt and specific diagnosis, enabling early treatment. 4
32. Shabshin N, Rosenberg ZS, Cavalcanti CF. MR imaging of iliopsoas musculotendinous injuries. Magn Reson Imaging Clin N Am. 2005;13(4):705-716. Review/Other-Dx N/A To discuss the role of MRI in the diagnosis of the iliopsoas musculotendinous injuries. MRI is most accurate for diagnosing nondynamic diseases of the iliopsoas compartment as well as for ruling out other abnormalities of the hip joint and surrounding structures. When a snapping hip is being investigated or corticosteroid injection is warranted, US can be of help in providing a dynamic study and by guiding the injection. 4
33. Song WS, Yoo JJ, Koo KH, Yoon KS, Kim YM, Kim HJ. Subchondral fatigue fracture of the femoral head in military recruits. J Bone Joint Surg Am. 2004;86-A(9):1917-1924. Review/Other-Dx 7 fractures in 5 patients To evaluate the clinical characteristics of subchondral fatigue fractures of the femoral head that occurred in young, healthy military recruits. Definite abnormal findings were observed on the initial radiographs of 4 hips in 3 patients, and the femoral head was markedly collapsed in 2/4 hips. Bone scintigrams were made of 5 hips in 4 patients. In all affected hips, MRI demonstrated a localized or diffuse bone-marrow-edema pattern in the femoral head and/or neck. A subchondral fracture line (a MR crescent sign) was identified in all hips. 4
34. Vande Berg BC, Malghem J, Goffin EJ, Duprez TP, Maldague BE. Transient epiphyseal lesions in renal transplant recipients: presumed insufficiency stress fractures. Radiology. 1994;191(2):403-407. Review/Other-Dx 16 patients; 47 joints To determine epiphyseal abnormalities in renal transplant recipients. In 42 of 47 joints, T1-weighted MR images depicted 106 ill-delimited areas of low signal intensity. At 1-year follow-up, all lesions had disappeared. T1-weighted MR images depicted nine well-delimited regions of normal signal intensity delineated by a rim of low signal intensity in seven joints. No lesion had completely disappeared at follow-up. Initial radiographs either were normal or showed patchy osteoporosis (13 joints). Follow-up radiographs showed epiphyseal collapse of two femoral heads, with well-delimited lesions on MR images, and subtle subchondral sclerosis in 21 noncollapsed epiphyses. 4
35. Yamamoto T, Schneider R, Bullough PG. Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI. Skeletal Radiol. 2001;30(5):247-254. Review/Other-Dx 7 patients To correlate the magnetic resonance imaging (MRI) features with the histopathologic findings in subchondral insufficiency fracture (SIF) of the femoral head. In all seven cases, MRI showed a bone marrow edema pattern in the femoral head, and a focal low-intensity band beneath the articular cartilage on some slices (not all) on the T1-weighted images. The shape of the low-intensity band varied: it was irregular and serpentine in four cases, well-delineated, smooth, and a mirror image to the articular surface in two cases, and parallel to the articular surface in one case. On histologic examination, the low-intensity band on MRI corresponded to a fracture line and its associated repair tissue. In all but one case, the band was not visible on T2-weighted or fat suppression images, and the proximal subchondral portion of the lesion had a homogeneous high signal intensity. This region of high signal intensity corresponded histopathologically to viable bone and marrow tissue with associated callus, edema, and vascular granulation tissue. 4
36. Zoga AC, Morrison WB. Technical considerations in MR imaging of the hip. Magn Reson Imaging Clin N Am. 2005;13(4):617-634, v. Review/Other-Dx N/A To discuss technical considerations in MRI of the hip. MRI has become an integral tool in diagnosis of hip disease including osseous, articular and periarticular soft-tissue structures. 4
37. Hodnett PA, Shelly MJ, MacMahon PJ, Kavanagh EC, Eustace SJ. MR imaging of overuse injuries of the hip. [Review] [65 refs]. Magn Reson Imaging Clin N Am. 17(4):667-79, vi, 2009 Nov. Review/Other-Dx N/A To review the importance of MRI in the evaluation of chronic hip pain and overuse injuries. Image interpretation of the hip can be difficult because of the complex anatomy and the varied pathology that athletes can present with. The differential diagnosis in adults is diverse and includes such common entities as stress fracture, avulsive injuries, snapping-hip syndrome, iliopsoas bursitis, FAI syndrome, tendinosis, and tears of the gluteal musculature. 4
38. Lee KS, Rosas HG, Phancao JP. Snapping hip: imaging and treatment. Semin Musculoskelet Radiol. 2013;17(3):286-294. Review/Other-Dx N/A To discuss the common and uncommon causes of snapping hip, the advanced imaging techniques that now give us a better understanding of the underlying mechanism, and an image-guided diagnostic and therapeutic algorithm that helps to identify surgical candidates. No results stated in abstract. 4
39. De Smet AA, Best TM. MR imaging of the distribution and location of acute hamstring injuries in athletes. AJR Am J Roentgenol. 2000;174(2):393-399. Review/Other-Dx 15 patients To determine the frequency of injury by muscle, involvement of one or more muscles, and location of injuries within the musculotendinous unit. We found that 10 athletes had injuries of a single muscle with six injuries of the biceps femoris, three of the semitendinosus, and one of the semimembranosus. In an additional five athletes, we found primary injuries of the biceps femoris and secondary injuries of the semitendinosus. The injuries occurred in diverse locations within the muscles including five injuries at the proximal musculotendinous junction, two at the distal musculotendinous junction, four within the proximal half of the muscle belly, and four in the distal half. All eight intramuscular injuries were located at the musculotendinous junction within the muscle. 4
40. Kingzett-Taylor A, Tirman PF, Feller J, et al. Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings. AJR Am J Roentgenol. 1999;173(4):1123-1126. Review/Other-Dx 35 patients To determine the prevalence of tendinosis and tears of gluteus medius and minimus muscles in patients presenting with buttock, lateral hip, or groin pain; describe the MR imaging findings; and discuss their probable relationship to the greater trochanteric pain syndrome. Thirty-five studies met our criterion of showing either tendinosis or tears of gluteus medius and minimus muscles as the primary positive finding. Eight patients had complete retracted tears of the gluteus medius, and 14 patients had partial tears; in 13 patients, MR findings were consistent with tendinosis. The gluteus minimus muscle was also involved in 10 patients. MR imaging findings were the same as those described for tears and tendinosis of other regions of the body. Surgical proof of a tendon tear was obtained in six patients. 4
41. Boutry N, Khalil C, Jaspart M, Marie-Helene V, Demondion X, Cotten A. Imaging of the hip in patients with rheumatic disorders. Eur J Radiol. 2007;63(1):49-58. Review/Other-Dx N/A To discuss imaging of the hip in patients with rheumatic disorders. IV gadolinium-chelate agents are used to differentiate between joint fluid and synovitis. 4
42. Panicek DM, Gatsonis C, Rosenthal DI, et al. CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: Report of the Radiology Diagnostic Oncology Group. Radiology. 1997;202(1):237-246. Experimental-Dx 316 patients To assess the relative accuracies of CT and MRI in the local staging of primary malignant bone and soft-tissue tumors. The CT images were obtained with and without contrast. No contrast was used in the MR images. There was no statistically significant difference between CT and MRI in determining tumor involvement of muscle, bone, joints, or neurovascular structures. The combined interpretation of CT and MRI did not statistically significantly improve accuracy. Inter-reader variability was similar for both modalities. 2
43. Sundaram M, McGuire MH, Herbold DR. Magnetic resonance imaging of soft tissue masses: an evaluation of fifty-three histologically proven tumors. Magn Reson Imaging. 1988;6(3):237-248. Review/Other-Dx 48 patients To evaluate confirmed soft-tissue masses in patients by comparing CT with MRO. Although MRO is better in anatomically staging soft-tissue tumors however, like CT, it is of limited value in characterizing soft-tissue sarcomas. 4
44. Zimmer WD, Berquist TH, McLeod RA, et al. Bone tumors: magnetic resonance imaging versus computed tomography. Radiology. 1985;155(3):709-718. Observational-Dx 52 patients To investigate the utility of MRI in the evaluation of bone tumors, identify criteria useful in distinguishing various types of tumors, and to compare MRI with CT. MRI was superior to CT in 33% of bone tumor cases, about equal to CT in 64%, and inferior to CT in 2%. For delineating the extent of tumor in soft tissue, MRI was superior to CT in 38% of cases and about equal to CT in 62%. CT was superior in all cases for demonstrating calcific deposits and pathologic fractures. In 4 patients with metal prostheses or surgical clips, MRI was superior to CT in documenting recurrent tumor because of artifactual degradation of the CT image. Direct sagittal and coronal images from MRI permit accurate assessment of the relationship of tumor to adjacent normal structures, including the physis, joints, and neurovascular structures. MRI is useful in the evaluation of bone tumors: it is of greatest value in evaluations of the peripheral skeleton, the medullary canal, soft tissues, and postoperative tumor recurrence. With a 0.15-T magnet, MRI is less useful in the evaluation of the axial skeleton and cortical bone. 3
45. Kursunoglu-Brahme S, Riccio T, Weisman MH, et al. Rheumatoid knee: role of gadopentetate-enhanced MR imaging. Radiology. 1990;176(3):831-835. Review/Other-Dx 10 control and 14 patients To evaluate the role of intravenously administered gadopentetate dimeglumine in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. T1-weighted images obtained prior to contrast material administration demonstrated an identical low-intensity signal from both effusion and inflamed synovium, and T2-weighted images demonstrated increased signal intensity in both cases. Intravenous administration of gadopentetate dimeglumine allowed distinction between effusion and abnormal synovium, with the effusion remaining of low signal intensity and the synovium demonstrating enhancement and increased signal intensity. 4
46. Choudur HN, Ellins ML. Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography. J Clin Ultrasound. 2011;39(1):6-11. Review/Other-Dx 100 patients To determine the feasibility and accuracy of ultrasound (US) -guided gadolinium injection for MR arthrography of shoulders, wrists, hips, and knee joints as an alternate technique to fluoroscopy. Ninety-nine of the 100 patients were successfully injected with gadolinium under US guidance. One patient had a vasovagal reaction after local anesthetic injection and the procedure was aborted. 4
47. Migliore A, Granata M, Tormenta S, et al. Hip viscosupplementation under ultra-sound guidance riduces NSAID consumption in symptomatic hip osteoarthritis patients in a long follow-up. Data from Italian registry. Eur Rev Med Pharmacol Sci. 2011;15(1):25-34. Observational-Dx 2,343 patients To investigate if NSAID consumption may be reduced by the use of ultrasound-guided intra-articular injection of several hyaluronic acid (HA) products in hip joint administered in patients affected by symptomatic hip OA. Regarding primary endpoint, the consumption of NSAIDs was reduced of 48.2% at the third month when compared with baseline values. This sparing effect increased at 12th and 24th month with a reduction respectively of 50% and 61% in comparison to baseline values. These differences were statistically significant. CONCLUSIONS: These data point out that intraarticular hyaluronan preparations provide OA pain relief and reduce NSAIDs consumption in a large cohort of patients for a long period of follow-up. Multiple courses of viscosupplementation (vs) are required to maintain low dose of NSAID consumption over time. NSAIDs consumption is strictly related to an high gastrointestinal and cardiovascular mortality and morbidity rate, instead HA intra-articular treatment is well tolerated and is associated with a low incidence of adverse effects. 3
48. Cardinal E, Buckwalter KA, Capello WN, Duval N. US of the snapping iliopsoas tendon. Radiology. 1996;198(2):521-522. Review/Other-Dx 3 patients To determine the value of ultrasound (US) in the diagnosis of snapping iliopsoas tendon. At US, an abnormal jerk of the iliopsoas tendon during hip motion was correlated with the painful audible snap. The motion of the contralateral iliopsoas tendon was smooth. No intraarticular abnormality was found in two patients, and an associated labral tear was suspected at arthrography in the third patient. The patient who underwent surgical release of the iliopsoas tendon had great improvement. 4
49. Deslandes M, Guillin R, Cardinal E, Hobden R, Bureau NJ. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190(3):576-581. Review/Other-Dx 14 patients; 18 hips To describe new mechanisms responsible for the snapping iliopsoas tendon using dynamic sonography. In 14 of 18 hips, the snapping was provoked by the sudden flipping of the iliopsoas tendon around the iliac muscle, allowing abrupt contact of the tendon against the pubic bone and producing an audible snap. Other causes of snapping iliopsoas tendon were bifid tendon heads flipping over one another (n = 3) and iliopsoas tendon impinging over an anterior paralabral cyst (n = 1). 4
50. Berquist TH. Diagnostic and therapeutic injections as an aid to musculoskeletal diagnosis. Semin intervent Radiol. 1993;10(4):326-343. Review/Other-Dx N/A To describe the use of diagnostic and therapeutic injections in MSK diagnosis. Diagnostic and therapeutic injections can be performed with image guidance in many regions. Valuable information about the site of symptomatology can be obtained for therapy planning. In many cases, the addition of local steroid injection may cause dramatic symptomatic improvement. The additional information obtained with these procedures provides an important complement to imaging. 4
51. Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med. 2004;32(7):1668-1674. Observational-Dx 40 patients To evaluate the diagnostic accuracy of these methods. Hip abnormality was clinically suspected in all cases with 98% accuracy (1 false positive). However, the nature of the abnormality was identified in only 13 cases with 92% accuracy. Magnetic resonance imaging variously demonstrated direct or indirect evidence of abnormality but overall demonstrated a 42% false-negative and a 10% false-positive interpretation. Magnetic resonance arthrography demonstrated an 8% false-negative and 20% false-positive interpretation. Response to the intra-articular injection of anesthetic was 90% accurate (3 false-negative and 1 false-positive responses) for detecting the presence of intra-articular abnormality. 3
52. Migliore A, Tormenta S, Lagana B, et al. Safety of intra-articular hip injection of hyaluronic acid products by ultrasound guidance: an open study from ANTIAGE register. Eur Rev Med Pharmacol Sci. 2013;17(13):1752-1759. Observational-Tx 1,906 patients To report in an extended series of patients the safety of eveloped a standardized technique for ultrasound guided intra-articular injection of the hip joint with the purpose of extending routine intra-articular injection of hyaluronans and steroids to the hip, as commonly used in the knee. The standardised technique was used to inject 1906 patients with 4002 injections of hyaluronan products over a four-year period. The treatment was well tolerated with few, and exclusively local, side effects. 2
53. Adler RS, Buly R, Ambrose R, Sculco T. Diagnostic and therapeutic use of sonography-guided iliopsoas peritendinous injections. AJR Am J Roentgenol. 2005;185(4):940-943. Review/Other-Dx 39 patients To describe the authors' experience using sonography guidance to perform therapeutic injections of the iliopsoas bursa. US-guided iliopsoas bursal/peritendinous injections are useful in determining the cause of hip pain. They can provide relief to most patients with iliopsoas tendinosis/bursitis after hip replacement. The results of injection alone are not as successful in cases of idiopathic iliopsoas tendinosis/bursitis, but the technique can help determine which patients may benefit from a surgical tendon release. 4
54. Pierannunzii L, Tramontana F, Gallazzi M. Case report: calcific tendinitis of the rectus femoris: a rare cause of snapping hip. Clin Orthop Relat Res. 2010;468(10):2814-2818. Review/Other-Dx 1 patient To report an unusual case in which a calcific tendinitis of the rectus femoris direct head impinged against the overlying iliacus muscle, resulting in a painful coxa saltans. The exclusive involvement of the direct head hid the calcium deposit on standard radiographs, whereas MRI suggested but poorly showed the tendon disease. Dynamic ultrasonography and CT scanning allowed a precise diagnosis and subsequent treatment with CT-guided steroid injection. 4
55. Luk WH, Au-Yeung AW, Yang MK. Diagnostic value of SPECT versus SPECT/CT in femoral avascular necrosis: preliminary results. Nucl Med Commun. 2010;31(11):958-961. Observational-Dx 22 patients To investigate the clinical value of conventional Tc99m-MDP SPECT against SPECT/CT in diagnosing hip AVN. A total of 22 patients and 24 symptomatic hips were analyzed. 7 hips (29%) were confirmed to have AVN. The AUCs obtained from receiver operator characteristic for trainee radiologist for SPECT vs SPECT/CT were 0.828 and 0.916, respectively. The AUC for specialist radiologist increased from 0.916 to 0.941 with CT. 2
56. Nishii T, Tanaka H, Nakanishi K, Sugano N, Miki H, Yoshikawa H. Fat-suppressed 3D spoiled gradient-echo MRI and MDCT arthrography of articular cartilage in patients with hip dysplasia. AJR Am J Roentgenol. 2005;185(2):379-385. Experimental-Dx 20 hips of 18 patients To assess the diagnostic ability of MDCT arthrography for acetabular and femoral cartilage lesions in patients with hip dysplasia. The sensitivity and specificity for the detection of any cartilage disorder (grade 1 or higher) were (observer 1/observer 2) 49%/67% and 89%/76%, respectively, on MRI, and 67%/67% and 89%/82%, respectively, on CT arthrography. The sensitivity and specificity for the detection of cartilage lesions with substance loss (grade 2 or higher) were (observer 1/observer 2) 47%/53% and 92%/87%, respectively, on MRI, and 70%/79% and 93%/94%, respectively, on CT arthrography. CT arthrography provided significantly higher sensitivity in the detection of grade 2 or higher lesions than MRI for both observers. Interobserver agreement in the detection of grade 2 or higher cartilage lesions was moderate (kappa = 0.53) on MRI and substantial (kappa = 0.78) on CT. 1
57. Nishii T, Tanaka H, Sugano N, Miki H, Takao M, Yoshikawa H. Disorders of acetabular labrum and articular cartilage in hip dysplasia: evaluation using isotropic high-resolutional CT arthrography with sequential radial reformation. Osteoarthritis Cartilage. 2007;15(3):251-257. Experimental-Dx Forty-one hips in 29 patients To evaluate the diagnostic ability of isotropic computed tomography (CT) arthrography with radial reformation technique for detection of acetabular labral and articular cartilage disorders, and evaluate those interactions in hip dysplasia The sensitivity, specificity and accuracy of CT arthrography were 97%/87%/92% for labral tear and 88%/82%/85% for acetabular cartilage disorder, respectively, using arthroscopic findings as the reference. The CT arthrography showed significantly higher frequency of labral and acetabular cartilage disorders at the anterior zones. Those zones with labral tear had significantly higher frequency of adjacent cartilage disorder than zones without labral tear. 2
58. Gazaille RE, 3rd, Flynn MJ, Page W, 3rd, Finley S, van Holsbeeck M. Technical innovation: digital tomosynthesis of the hip following intra-articular administration of contrast. Skeletal Radiol. 2011;40(11):1467-1471. Review/Other-Dx 1 patient To demonstrate the clinical use of digital tomosynthesis in the depiction of labral and chondral pathology in the setting of post-operative CAM-type impingement of the hip following intra-articular administration of dilute iodinated contrast. A partial tear of the labrum and clinically significant acetabular chondral abnormalities were demonstrated with the use of digital tomosynthesis with superb anatomic detail. 4
59. Jacobsen S, Romer L, Soballe K. Degeneration in dysplastic hips. A computer tomography study. Skeletal Radiol. 2005;34(12):778-784. Observational-Dx 193 patients To determine the pattern of degenerative change in moderate to severely dysplastic hips in young patients. In dysplastic hips the anterior acetabular sector angle was significantly and inversely associated to femoral anteversion (p < 0.001). The center-edge (CE) angle, the acetabular angle (AA), and the acetabular depth ratio (ADR) were significantly interrelated (p < 0.001; correlation coefficients ranging from -0.8 to 0.7). Fifty-one hips were subluxated (24R/27L). There were no cases of complete dislocation. The formation of subchondral cysts or osteophytes in dysplastic hips was significantly associated with reduced minimum joint space width (p ranging from 0.005 to 0.02). However, in 67 hips with acetabular cysts, only 6 hips had minimum joint space widths = 2.0 mm (8.9%) in the coronal plane. In 96 cases with acetabular cysts found in the sagittal plane, 43 cases had minimum joint space widths = 2.0 mm (44.7%). Bony rim detachment at the site of labral insertion was recorded in 30 hips. Twenty-three of these were dysplastic (p = 0.01). 4
60. Jacobsen S, Romer L, Soballe K. The other hip in unilateral hip dysplasia. Clin Orthop Relat Res. 2006;446:239-246. Observational-Dx 197 patients, 41 control To review transverse pelvic computed tomography scans of 197 consecutively referred adult patients with hip pain thought to be secondary to developmental dysplasia. The joint anatomy of patients with developmental dysplasia differed from that of control subjects in almost all aspects. Acetabular anteversion was larger in control subjects compared with patients with developmental dysplasia. We found inverse relationships between femoral anteversion and the anterior acetabular sector angle and coronal and sagittal center-edge angles in dysplastic hips, and also between femoral neck-shaft angles and the anterior acetabular sector angle. There was an inverse relationship between reduced anterior support developmental dysplasia in which plain radiographs suggested unilateral dysplastic abnormality only, computed tomography scans revealed both hips to be abnormal. 4
61. Lee CB, Millis MB. Patient selection for rotational pelvic osteotomy. Instr Course Lect. 2013;62:265-277. Review/Other-Dx N/A To review a systematic approach to evaluation of the variables in selecting an optimal treatment program for the patient with symptomatic acetabular dysplasia. Preserving the native hip is the first choice in young, active patients with minimal arthrosis. Techniques in rotational pelvic osteotomy have evolved to offer long-term benefits, but appropriate patient selection is an important determinant of success. Applying a stepwise approach when evaluating adult patients with acetabular dysplasia and understanding current outcomes and predictive data will allow the orthopaedic surgeon to choose appropriate candidates for pelvic osteotomy. 4
62. Beaule PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ. Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res. 2005;23(6):1286-1292. Observational-Dx 30 patients and 36 hips; 12 patients and 20 hips To assess the anterior and posterior concavity of the femoral head-neck junction in painful, nondysplastic hips. The mean alpha angle for the symptomatic and the control group were: 66.4 versus 43.8 (p=0.001), and for the beta angle 40.2 versus 43.8 (p=0.011), respectively. All but one of the symptomatic hips had a labral tear with 61% of these hips having associated cartilage damage. 4
63. Hetsroni I, Larson CM, Dela Torre K, Zbeda RM, Magennis E, Kelly BT. Anterior inferior iliac spine deformity as an extra-articular source for hip impingement: a series of 10 patients treated with arthroscopic decompression. Arthroscopy. 2012;28(11):1644-1653. Observational-Tx 10 patients To describe an arthroscopic technique for decompression of a prominent anterior inferior iliac spine (AIIS) leading to extra-articular hip impingement and to provide short-term outcome after this procedure. The mean age was 24.9 years, with 8 of 10 patients aged younger than 30 years. In 9 patients, an anterior cam lesion was identified and decompressed before the AIIS decompression. The mean follow-up time was 14.7 months (range, 6 to 26 months). Hip flexion range of motion improved from 99 degrees +/- 7 degrees before surgery to 117 degrees +/- 8 degrees after surgery (P < .001). The modified Harris Hip Score improved from 64 +/- 18 before surgery to 98 +/- 2 at latest follow-up after surgery (P < .001). 2
64. Tannast M, Hanke M, Ecker TM, Murphy SB, Albers CE, Puls M. LCPD: reduced range of motion resulting from extra- and intraarticular impingement. Clin Orthop Relat Res. 2012;470(9):2431-2440. Observational-Dx 13 hips with LCPD, 22 hips with FAI, 27 normal hips To review whether the location of impingement zones, the presence of additional extraarticular impingement, and the resulting ROM differ between hips with LCPD and normal hips or hips with FAI. The location of impingement zones in hips with LCPD differed compared with the FAI/normal groups. Intra- and extraarticular impingement was more frequent in LCPD (79% and 86%, respectively) compared with normal (15%, 15%) and FAI hips (36%, 14%). Hips with LCPD had decreased amplitude for all hip motions (flexion, extension, abduction, adduction, internal and external rotation) compared with FAI or normal. 4
65. Czerny C, Hofmann S, Urban M, et al. MR arthrography of the adult acetabular capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol. 1999;173(2):345-349. Experimental-Dx 40 patients and six cadavers To describe the appearance of the acetabular capsular-labral complex on MR arthrography and to correlate this appearance with surgical findings in adult patients and with gross anatomic findings in cadavers. MR images were with contrast. MR arthrography images of the T-weighted three-dimensional gradient-echo sequences allowed visualization of the anatomic structures. The normal labrum was triangular, without any sublabral sulcus, and of homogeneous low signal intensity. A recess between the labrum and the joint capsule could be identified in instances in which no thickened labrum was present. Labral lesions included labral degeneration, a tear, or a detached labrum either with or without thickening of the labrum. The sensitivity for detection and correct staging of labral lesions with MR arthrography in the patient study was 91%; the specificity, 71%; and the accuracy, 88%. 2
66. Neumann G, Mendicuti AD, Zou KH, et al. Prevalence of labral tears and cartilage loss in patients with mechanical symptoms of the hip: evaluation using MR arthrography. Osteoarthritis Cartilage. 2007;15(8):909-917. Observational-Dx 100 patients To determine the prevalence of labral tears and cartilage lesions in patients with mechanical symptoms of the hip using magnetic resonance (MR) arthrography. On MR arthrography, labral tears were found in 66 patients (66% prevalence) with 13 having more than one location involved. Locations were 19 lateral (13 simple, six complex), 54 anterior (39 simple, 15 complex), eight posterior (six simple, two complex). Cartilage lesions were found in 76 patients (76% prevalence) with 53 demonstrating involvement of more than one compartment. The most common finding was cartilage thinning <50% in 99 regions in 44 patients. Cartilage thinning >50% was shown in 34 patients in 67 areas. When we correlated the grade of cartilage abnormality with the grade of labral tear, we found a statistically significant correlation (r=0.29; P< or =0.01). The size of cartilage abnormality was correlated with the grade of labral tear in the lateral acetabulum (r=0.38; P<0.001), anterior acetabulum (r=0.22; P< or =0.002), and lateral femoral head (r=0.29; P< or =0.004). The grade of cartilage loss was correlated with the grade of BME (r=0.44; P< or =0.001). 3
67. Petersilge CA. MR arthrography for evaluation of the acetabular labrum. Skeletal Radiol. 2001;30(8):423-430. Review/Other-Dx N/A To review the normal anatomy of the hip, the clinical presentation of internal derangement, and the technique for performing MR arthrography. With the joint distention provided by MR arthrography, labral detachments and intrasubstance tears can be identified and differentiated from the many varied appearances of the asymptomatic labrum. 4
68. Yoon LS, Palmer WE, Kassarjian A. Evaluation of radial-sequence imaging in detecting acetabular labral tears at hip MR arthrography. Skeletal Radiol. 2007;36(11):1029-1033. Review/Other-Dx 54 arthrograms To investigate whether radial imaging demonstrates labral tears not visible on standard imaging planes. Using standard imaging planes, 50 anterosuperior, 31 posterosuperior, 10 anteroinferior, and 9 posteroinferior labral tears were detected in 54 MR arthrograms of the hip. Using radial sequences alone, 44 anterosuperior, 25 posterosuperior, 9 anteroinferior, and 5 posteroinferior labral tears were detected. In all four areas of the labrum, the radial imaging did not show any labral tear not seen on standard imaging planes. 4
69. Banks DB, Boden RA, Mehan R, Fehily MJ. Magnetic resonance arthrography for labral tears and chondral wear in femoroacetabular impingement. Hip Int. 2012;22(4):387-390. Experimental-Dx 69 hips To assess the efficacy of MRA in diagnosing labral tears and chondral damage in patients with FAI in our institution. The findings at MRA were compared to those found intraoperatively. For labral tears, sensitivity, specificity and accuracy were 81%, 51% and 58% respectively. For chondral wear these figures were 17%, 100%, and 55% respectively. 2
70. Ziegert AJ, Blankenbaker DG, De Smet AA, Keene JS, Shinki K, Fine JP. Comparison of standard hip MR arthrographic imaging planes and sequences for detection of arthroscopically proven labral tear. AJR Am J Roentgenol. 2009;192(5):1397-1400. Observational-Dx 144 patients To compare multiple imaging planes and two pulse sequences for detection of arthroscopically proven labral tears. Among the 144 tears, 97.2% were identified as definitely present on images obtained with at least one of the sequences. The axial oblique sequence had the highest individual detection rate (85.0%). The detection rates for the sagittal T1-weighted (74.6%), coronal T1-weighted (67.4%), and coronal T2-weighted (63.6%) sequences were intermediate. Detection rates with the axial T1-weighted (29.9%) and sagittal oblique (18.2%) sequences were low. With the combination of three sequences (coronal T2-weighted with fat saturation, axial oblique T1-weighted with fat saturation, and sagittal T1-weighted with fat saturation), 95.8% of the 144 tears were identified as definitely present. Twenty-eight percent of tears had a signal intensity less than that of gadolinium or fluid. 3
71. Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE. Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology. 2005;236(2):588-592. Review/Other-Dx 40 patients To retrospectively analyze magnetic resonance (MR) arthrographic findings in patients with clinical cam-type femoroacetabular impingement. At imaging, in 40 patients (22 male, 18 female) with a mean age of 36.5 years, 39 of 42 hips (93%) had an abnormal alpha angle, with a mean angle of 69.7 degrees; 40 of 42 (95%) had an anterosuperior cartilage abnormality; and 42 of 42 (100%) had an anterosuperior labral tear. Thirty-seven of 42 hips (88%) had the triad. Six had paralabral cysts, 17 had an os acetabuli, and two had synovial herniation pits. Surgical comparison for 11 hips led to confirmation of all labral and cartilage abnormalities seen at imaging. 4
72. Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J. Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology. 2006;240(3):778-785. Observational-Dx 50 patients To retrospectively characterize magnetic resonance (MR) arthrographic findings in patients with cam femoroacetabular impingement (FAI) and in those with pincer FAI. At surgery, hips in 33 patients were classified as having cam FAI and hips in 17 patients were classified as having pincer FAI. In both groups, the mean age of patients was 28.8 years. There were significantly more men (n = 27) with cam FAI and more women (n = 14) with pincer FAI. The alpha angle was significantly larger in patients with cam FAI at the anterior and anterosuperior positions. The acetabulum was significantly deeper in patients with pincer FAI than in patients with cam FAI. Cartilage lesions at the anterosuperior and superior positions were significantly larger in patients with cam FAI than in patients with pincer FAI. Cartilage lesions at the posteroinferior position were significantly larger and labral lesions at the posterior and posteroinferior positions were more pronounced in patients with pincer FAI than in patients with cam FAI. Osseous abnormalities were not significantly different between the groups. Osseous bump formation at the femoral neck was significantly more common in patients with cam FAI than in patients with pincer FAI. 2
73. Zaragoza E, Lattanzio PJ, Beaule PE. Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. Hip Int. 2009;19(1):18-23. Experimental-Dx 46 patients (48 hips) To evaluate the diagnostic performance of MRI with gadolinium arthrography in detecting acetabular cartilage delamination in patients with pre-arthritic hip pain. On MRA all hips had a labral tear confirmed at surgery. At surgery 30 hips had evidence of acetabular cartilage delamination, 4 hips had ulceration and 14 had no articular cartilage damage. The majority of labral tears and cartilage damage were located in the antero-superior quadrant. The sensitivity and specificity of MRA detection of cartilage delamination confirmed at surgery were 97% and 84%, respectively. The positive and negative predictive values of the MRA finding were 90% and 94%, respectively. 3
74. Mosher TJ. Musculoskeletal imaging at 3T: current techniques and future applications. Magn Reson Imaging Clin N Am. 2006;14(1):63-76. Review/Other-Dx N/A To review the current techniques and future applications at 3T MRI. Initial experience with 3T MRI in the evaluation of the hip joint has been positive. 4
75. Ramnath RR. 3T MR imaging of the musculoskeletal system (Part II): clinical applications. Magn Reson Imaging Clin N Am. 2006;14(1):41-62. Review/Other-Dx N/A To discuss the utility/advantages of 3T MRI and its clinical applications in the MSK system. Because of the enhanced signal-to-noise ratio, the higher spatial resolution, and the greater contrast-to-noise of intrinsic joint structures at higher field strengths, 3T MRI has the potential to improve diagnostic abilities in the MSK system vastly, which translates into better patient care and management. 4
76. Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology. 2006;238(2):706-711. Review/Other-Dx 8 patients To prospectively compare imaging of the acetabular labrum with 3.0-T magnetic resonance (MR) imaging and 1.5-T MR arthrography. Presence of labral lesions, paralabral cysts, articular cartilage lesions, subchondral cysts, osteophytes, and synovial herniation pits was recorded. There was arthroscopic correlation of findings in five patients. MR imaging depicted four surgically confirmed labral tears that were identified at MR arthrography, as well as one that was not visualized at MR arthrography. MR imaging helped identify all other pathologic conditions that were diagnosed at MR arthrography and helped identify one additional surgically confirmed focal articular cartilage lesion. 4
77. Kim SD, Jessel R, Zurakowski D, Millis MB, Kim YJ. Anterior delayed gadolinium-enhanced MRI of cartilage values predict joint failure after periacetabular osteotomy. Clin Orthop Relat Res. 2012;470(12):3332-3341. Observational-Dx 43 hips from 41 patients To assess whether the dGEMRIC index of the anterior joint would better predict premature joint failure after PAOs than the coronal dGEMRIC index as previously reported. The two cohorts were similar in age and sex distribution. Severity of dysplasia was similar as measured by lateral center-edge, anterior center-edge, and Tonnis angles. Preoperative pain, joint space width, Tonnis grade, and coronal and sagittal dGEMRIC indexes differed between groups. The dGEMRIC index in the anterior weightbearing region of the hip was lower in the prematurely failed group and was the best predictor. 2
78. Rakhra KS, Lattanzio PJ, Cardenas-Blanco A, Cameron IG, Beaule PE. Can T1-rho MRI detect acetabular cartilage degeneration in femoroacetabular impingement?: a pilot study. J Bone Joint Surg Br. 2012;94(9):1187-1192. Experimental-Dx 10 patients with cam-type FAI and 10 control patients To determine the normal T1rho profile of cartilage within the hip and to identify any differences in T1rho profile between the normal and symptomatic femoroacetabular impingement (FAI) hip. The mean T1rho relaxation times for full cartilage thickness of control and FAI hips were similar (37.17 ms (SD 9.95) and 36.71 ms (SD 6.72), respectively). The control group demonstrated a T1rho value trend, increasing from deep to superficial cartilage layers, with the middle third having significantly greater T1rho relaxation values than the deepest third (p = 0.008). The FAI group demonstrated loss of this trend. The deepest third in the FAI group demonstrated greater T1rho relaxation values than controls (p = 0.028). 3
79. Bittersohl B, Hosalkar HS, Kim YJ, et al. T1 assessment of hip joint cartilage following intra-articular gadolinium injection: a pilot study. Magn Reson Med. 2010;64(4):1200-1207. Experimental-Dx 9 patients to study contrast infiltration process; 27 patients scanned with intra-articular delayed gadolinium-enhanced MRI of cartilage To define the feasibility of cartilage assessment in symptomatic femoroacetabular impingement patients using intra-articular delayed gadolinium-enhanced MRI of cartilage (ia-dGEMRIC). This pilot study demonstrates a significant difference between the pre- and postcontrast T(1) values (P < 0.001) remaining constant for 45 min. We noted higher mean T(1) values in morphologically normal-appearing cartilage than in damaged cartilage, which was statistically significant for all zones except the anterior-superior zone. Intraobserver (0.972) and interobserver correlation coefficients (0.933) were statistically significant. 2
80. Pollard TC, McNally EG, Wilson DC, et al. Localized cartilage assessment with three-dimensional dGEMRIC in asymptomatic hips with normal morphology and cam deformity. J Bone Joint Surg Am. 2010;92(15):2557-2569. Experimental-Dx 32 subjects To investigate the potential of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) to detect cartilage disease in asymptomatic hips with cam deformities compared with morphologically normal hips, establish whether dGEMRIC could identify advanced disease in hips with positive clinical findings, and establish whether cartilage damage correlated with the severity of the cam deformity. Of thirty-two subjects (mean age, fifty-two years), nineteen had cam deformities. Hips with a cam deformity had reduced acetabular glycosaminoglycan content compared with normal hips (mean T1(acet)/T1(total), 0.949 and 1.093, respectively; p = 0.0008). Hips with a positive impingement test result had global depletion of glycosaminoglycan compared with hips with a negative result (mean T1(total), 625 ms versus 710 ms; p = 0.0152). T1(acet) inversely correlated with the magnitude of the alpha angle (r = -0.483, p = 0.0038), suggesting that the severity of cartilage damage correlates with the magnitude of the cam deformity. All of these differences occurred irrespective of genetic predisposition. 2
81. James SL, Ali K, Malara F, Young D, O'Donnell J, Connell DA. MRI findings of femoroacetabular impingement. AJR Am J Roentgenol. 2006;187(6):1412-1419. Observational-Dx 46 patients To evaluate MRI in the identification of labral and articular cartilage lesions in patients with a clinical suspicion of femoroacetabular impingement. Seven patients showed labral tears on MRI that were confirmed surgically in all cases. Thirty-seven patients (97%) of the 38 surgically confirmed cases had lesions of the labral-chondral transitional zone on MRI. The sites of labral-chondral transitional zone abnormalities at arthroscopy were 50% anterosuperior, 36% anterosuperior and superolateral, 11% superolateral, and 3% superolateral and posterosuperior. The site was identified correctly in 92% (reviewer 1) and 95% (reviewer 2) of cases on MRI. Separate acetabular cartilage abnormality was surgically identified in 39% of cases, and femoral cartilage lesions were found in 20%. The acetabular chondral lesions were correctly identified in 89-94% of cases. 2
82. Mintz DN, Hooper T, Connell D, Buly R, Padgett DE, Potter HG. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging. Arthroscopy. 2005;21(4):385-393. Observational-Dx 92 patients To evaluate the ability of optimized, noncontrast MRI to identify tears of the acetabular labrum and defects in articular cartilage. Of the 92 patients studied, each of 2 radiologists correctly identified 83 (94%) and 84 (95%) of the 88 labral tears present at surgery, respectively. There was 92% interobserver agreement on the MRI studies. For articular cartilage defects on the femoral head and acetabulum, there was good agreement (92% and 86% within 1 grade) between MRI and surgical grading and between the 2 MR readers (kappa of 0.8 for femoral head cartilage and 0.7 for acetabular cartilage). 2
83. Vahlensieck M, Peterfy CG, Wischer T, et al. Indirect MR arthrography: optimization and clinical applications. Radiology. 1996;200(1):249-254. Experimental-Dx 14 controls; 17 patients To evaluate and optimize a method for producing magnetic resonance (MR) images similar to MR arthrograms of multiple synovial joints with intravenous gadopentetate dimeglumine injection. Fat-saturated images obtained after 10 minutes of exercise and administration of 0.1 mmol/kg gadopentetate dimeglumine were similar to those obtained after intraarticular injection of contrast medium. Exercising the joint yielded the strongest joint-cavity enhancement. Increasing the dose of contrast medium in the unexercised joint did not statistically significantly improve the contrast-to-noise ratio. Rotator cuff tears, meniscal tears, and cartilage defects were better delineated with this method than with unenhanced MR imaging and showed good correlation with arthroscopic results. 3
84. Winalski CS, Aliabadi P, Wright RJ, Shortkroff S, Sledge CB, Weissman BN. Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications. Radiology. 1993;187(1):179-185. Review/Other-Dx 10 subjects To determine the feasibility of enhancing the joint fluid with IV injection of gadopentetate dimeglumine. The arthrographic effect may provide a more convenient alternative to intra-articular injection of gadopentetate dimeglumine for MR arthrography. 4
85. Zoga AC, Schweitzer ME. Indirect magnetic resonance arthrography: applications in sports imaging. [Review] [24 refs]. Top Magn Reson Imaging. 14(1):25-33, 2003 Feb. Review/Other-Dx N/A To review indirect MR arthrography as an imaging tool with several advantages and disadvantages over both direct MR arthrography and unenhanced MSK MRI. Advantages of indirect MR arthrography include enhancement of both intra-articular and extra-articular pathology without the need for an invasive, fluoroscopically guided arthrogram, as well as high sensitivity for re-injury in postoperative patients. Some potential disadvantages of this technique are enhancement of normal vascular tissues and difficulty in making a diagnosis dependent upon joint space distension in the absence of an effusion. 4
86. Smith TO, Hilton G, Toms AP, Donell ST, Hing CB. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol. 2011;21(4):863-874. Meta-analysis 19 studies; 881 hips To determine the sensitivity and specificity of MRI and MRA in diagnosing acetabular labral tears using meta-analysis. Nineteen papers assessing 881 hips were reviewed. Conventional MRI was assessed in 13 studies and MRA was assessed in 16 studies. Whilst both MRI (0.5-3T) and MRA (0.5-3T) presented with a moderate sensitivity and specificity (sensitivity 66%, 87%; specificity 79%, 64%), diagnostic accuracy of MRA appeared to be superior to MRI in detecting acetabular labral tears on ROC curve interpretation. The literature poorly described population characteristics, assessor blinding, with limited sample sizes. M
87. Christie-Large M, Tapp MJ, Theivendran K, James SL. The role of multidetector CT arthrography in the investigation of suspected intra-articular hip pathology. Br J Radiol. 2010;83(994):861-867. Observational-Dx 96 patients To evaluate the role of multidetector CT (MDCT) arthrography in the diagnosis of intra-articular hip pathology. We detected 28 labral tears (24 anterior, 2 anterolateral, 1 lateral and 1 posterolateral). An abnormal labral-chondral transitional zone was seen in 9 patients and 4 patients had surface labral fraying. We identified three paralabral cysts. Acetabular cartilage loss was detected in 45 and femoral cartilage loss in 9 patients. An abnormal anterior femoral head and neck junction was present in 18 hips and fibrocystic change in 8. Acetabular retroversion was present in 11 hips. 63 sets of patient notes were reviewed, of which 49 were in-patients with abnormal MDCT arthrogram findings. Surgical correlation was available in 27 patients. There was a discrepancy between the findings of a labral tear in one patient (false negative, 90% sensitivity and 100% specificity) and the presence of acetabular cartilage loss (88% sensitivity and 100% specificity) and femoral cartilage loss (94% sensitivity and 100% specificity) in three patients 3
88. Ha YC, Choi JA, Lee YK, et al. The diagnostic value of direct CT arthrography using MDCT in the evaluation of acetabular labral tear: with arthroscopic correlation. Skeletal Radiol. 2013;42(5):681-688. Observational-Dx 58 hips To determine the sensitivity, specificity, and accuracy of MDCT arthrography (CTA) for the diagnosis of acetabular labral tear and sulcus; to correlate tear types using the Lage classification system on CTA compared with the arthroscopic classification; and, to correlate CTA localization with arthroscopic localization. Forty-one of the 58 hips were diagnosed as labral tears on CT arthrography. Forty-three of the 58 hips were shown to have a labral tear on arthroscopy. Sensitivity, specificity, and accuracy for detecting labral tear and sulcus by CTA were 90.7%, 86.7%, and 89.7%, and 93.8%, 97.6% and 96.6% respectively for observer 1, and 90.7% and 80.0%, 87.9% and 87.5%, 95.2%, and 93.1 % respectively for observer 2. Thirty-five out of 41 hips (85%) that were diagnosed with labral tear on CTA correlated substantially with arthroscopic Lage classification (kappa coefficient = 0.65). CTA and arthroscopic findings showed similar distribution patterns of the tears with most lesions located in antero- and postero-superior areas (p = 0.013). 2
89. Reurink G, Jansen SP, Bisselink JM, Vincken PW, Weir A, Moen MH. Reliability and validity of diagnosing acetabular labral lesions with magnetic resonance arthrography. J Bone Joint Surg Am. 2012;94(18):1643-1648. Observational-Dx 95 hips To establish the interobserver reliability and the validity of magnetic resonance arthrography for detecting lesions of the acetabular labrum in a retrospective case series. At arthroscopy, ninety-one labral lesions were identified in the ninety-five hips. The interobserver reliability of detecting labral lesions with magnetic resonance arthrography was fair (kappa=0.268). Magnetic resonance arthrography, as interpreted by observers A and B, showed a sensitivity of 86% and 86%, specificity of 75% and 50%, negative predictive value of 19% and 13%, and positive predictive value of 99% and 98%, respectively. 2
90. Harris-Hayes M, Commean PK, Patterson JD, Clohisy JC, Hillen TJ. Bony abnormalities of the hip joint: a new comprehensive, reliable and radiation-free measurement method using magnetic resonance imaging. J Hip Preserv Surg. 2014;1(2):62-70. Observational-Dx 32 hips To develop comprehensive and reliable radiation-free methods to quantify femoral and acetabular morphology using MRI. Interrater reliability was good to excellent for all raters for AV, FV, FNA, and LCEA (ICCs: 0.82-0.98); good to excellent between experienced raters (ICCs: 0.78-0.86) and poor to good between novice and experienced raters (ICCs: 0.23-0.78) for AA. Intrarater reliability was good to excellent for all raters for AV, FV and FNA (ICCs: 0.93-0.99); for one experienced and novice rater for LCEA (ICCs: 0.84-0.89); moderate to excellent for the experienced raters for AA (ICCs: 0.72-0.89). Intrarater reliability was poor for the second experienced rater for LCEA (ICC: 0.56), due to a single measurement error and for the novice rater for AA (ICCs: 0.17-0.38). 3
91. Bruce W, Van Der Wall H, Storey G, Loneragan R, Pitsis G, Kannangara S. Bone scintigraphy in acetabular labral tears. Clin Nucl Med. 2004;29(8):465-468. Review/Other-Dx 27 patients To analyze retrospectively bone scintigraphy in 27 patients with acetabular labral tears diagnosed by MRI/arthroscopy. Patients with labral tears had hyperemia of the superior or superomedial aspect of the acetabulum and increased delayed uptake in either a focal superior pattern or in an "eyebrow" pattern of a superomedial tear. This pattern was not seen in any other sources of hip pathology. 4
92. Matar WY, May O, Raymond F, Beaule PE. Bone scintigraphy in femoroacetabular impingement: a preliminary report. Clin Orthop Relat Res. 2009;467(3):676-681. Experimental-Dx 25 patients To determine the sensitivity and specificity of bone scans in diagnosing FAI and describe its findings on nuclear imaging. Forty-six of the 50 hips had bony abnormalities on radiographs and 26 hips were diagnosed with FAI according to our criteria. Twenty-two of these 26 hips showed an increased uptake on SPECT representing true-positives. There were four false-positives, nine false-negatives, and 15 true-negatives. Sensitivity of bone SPECT was 84.7%, specificity 62.5%, positive predictive value 71%, and negative predictive value 78.9%. 3
93. Eagle S, Potter HG, Koff MF. Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis. [Review]. Journal of Orthopaedic Research. 35(3):412-423, 2017 03. Review/Other-Dx N/A To provide background information about MRI signal generation and decay (T1 and T2 values), the utility of morphologic MRI, and the quantitative MRI techniques of T1rho , T2 , and T2 * mapping, to evaluate subjects with traumatic knee injuries, such as ACL rupture. No results stated in abstract. 4
94. Sahin M, Calisir C, Omeroglu H, Inan U, Mutlu F, Kaya T. Evaluation of Labral Pathology and Hip Articular Cartilage in Patients with Femoroacetabular Impingement (FAI): Comparison of Multidetector CT Arthrography and MR Arthrography. Pol J Radiol. 2014;79:374-380. Observational-Dx 14 patients To compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods. While the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p<0.05). The same values for acetabular cartilage assessment were 89/56, 40/60, 71/71 (p>0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (kappa=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (kappa=0.76 for MRa and kappa=0.86 for CTa). 3
95. Lee S, Nardo L, Kumar D, et al. Scoring hip osteoarthritis with MRI (SHOMRI): A whole joint osteoarthritis evaluation system. J Magn Reson Imaging. 2015;41(6):1549-1557. Observational-Dx 98 patients To develop a semi-quantitative MR-based hip osteoarthritis (OA) evaluation system (Scoring hip osteoarthritis with MRI, SHOMRI), and to test its reproducibility and face validity. ICC values were in the excellent range, 0.91 to 0.97. Cohen's Kappa values and percent agreement ranged from 0.55 to 0.79 and 66 to 99%, respectively. SHOMRI demonstrated significant correlations with KL and OARSI gradings as well as with clinical parameters, HOOS and ROM (P < 0.05). Among the SHOMRI features, subchondral cyst and bone marrow edema pattern showed the highest correlation with HOOS and ROM. 3
96. Roemer FW, Hunter DJ, Winterstein A, et al. Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings. Osteoarthritis Cartilage. 2011;19(8):946-962. Observational-Dx 52 patients To develop a semiquantitative MRI-based scoring system (HOAMS) of hip osteoarthritis (OA) and test its reliability and validity. Distribution of radiographic grading was: KL 0=12 (27%), KL 1=11 (25%), KL 2=14 (32%), KL 3=5 (11%) and KL 4=2 (5%). Intra-reader reliability for the different features ranged from 0.18 (cysts) to 0.85 (cartilage). Inter-reader reliability ranged between 0.15 (cysts) and 0.85 (BMLs). Low kappas were due to low frequencies of some features as overall percent agreement was good to excellent (83.8% and 83.1%). There was a strong association between MRI-detected lesions and radiographic severity (P=0.002). Non-significant trends were observed between MRI features and clinical outcomes. 2
97. Laine JC, Denning JR, Riccio AI, Jo C, Joglar JM, Wimberly RL. The use of ultrasound in the management of septic arthritis of the hip. J Pediatr Orthop B. 2015;24(2):95-98. Review/Other-Dx N/A To assess septic arthritis of the hip in a pediatric population. The need for MRI to further evaluate the patient for adjacent infection before treatment is debatable. Once an effusion is confirmed on ultrasonography, we have found that septic arthritis of the hip does not need advanced imaging before arthrotomy and debridement. Patients who fail to clinically respond to an initial hip arthrotomy and appropriate antibiotics may benefit from an MRI for the identification of concomitant infections that may require surgical intervention. 4
98. Wang JH, Chi CY, Lin KH, Ho MW, Kao CH. Tuberculous arthritis--unexpected extrapulmonary tuberculosis detected by FDG PET/CT. Clin Nucl Med. 2013;38(2):e93-94. Review/Other-Dx 1 patient To present a report regarding a 62-year-old man with fever, chronic cough, arthralgia of the left side of the hip, and body weight loss. Chest radiograph showed increased infiltration in both upper lungs, and the acid-fast stain of sputum was positive. Whole-body PET/CT scan revealed a lesion with intense FDG uptake in the joint of the side left of the hip. Osteoarthritis of the hip was initially impressed by an orthopedist. However, tuberculous arthritis was subsequently confirmed by deep pus culture. 4
99. Goldman AB, DiCarlo EF. Pigmented villonodular synovitis. Diagnosis and differential diagnosis. Radiol Clin North Am. 1988;26(6):1327-1347. Review/Other-Dx N/A To describe pigmented villonodular synovitis and outline characteristics that distinguish it from other diseases. No results stated in abstract. 4
100. Klompmaker J, Veth RP, Robinson PH, Molenaar WM, Nielsen HK. Pigmented villonodular synovitis. Arch Orthop Trauma Surg. 1990;109(4):205-210. Review/Other-Tx 18 patients To describe 18 patients suffering from localized or diffuse pigmented villonodular synovitis including their symptoms and therapeutic results. No results stated in abstract. 4
101. Won SH, Lee YK, Ha YC, Suh YS, Koo KH. Improving pre-operative planning for complex total hip replacement with a Rapid Prototype model enabling surgical simulation. Bone Joint J. 2013;95-B(11):1458-1463. Observational-Tx 21 hips To evaluate whether a Rapid Prototype (RP) model, which is a life-sized reproduction based on three-dimensional CT scans, can determine the feasibility of THR and provide information about the size and position of the acetabular component in severe acetabular deformities. All the acetabular components and femoral stems had radiographic evidence of bone ingrowth and stability. There was no detectable wear and no peri-prosthetic osteolysis (Figs 2 and 3). Brooker grade III heterotopic ossification was present in one hip. The mean Harris hip score was 79.9 points (52 to 100) at the final follow-up. 2
102. American College of Radiology. ACR Appropriateness Criteria®: Metastatic Bone Disease. Available at: https://acsearch.acr.org/docs/69431/Narrative/. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for metastatic bone disease. N/A 4
103. Bencardino JT, Stone TJ, Roberts CC, et al. ACR Appropriateness Criteria(R) Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae. J Am Coll Radiol. 2017;14(5S):S293-S306. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for stress (fatigue/insufficiency) fracture, including sacrum, excluding other vertebrae. No results stated in abstract. 4
104. American College of Radiology. ACR Appropriateness Criteria®: Primary Bone Tumors. Available at: https://acsearch.acr.org/docs/69421/Narrative/. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for primary bone tumors. N/A 4
105. American College of Radiology. ACR Appropriateness Criteria®: Osteoporosis and Bone Mineral Density. Available at: https://acsearch.acr.org/docs/69358/Narrative/. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for Osteoporosis and bone mineral density. N/A 4
106. American College of Radiology. ACR Appropriateness Criteria®: Osteonecrosis of the Hip. Available at: https://acsearch.acr.org/docs/69425/Narrative/. Accessed April 22, 2015. Review/Other-Tx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for Osteonecrosis of the Hip. N/A 4