Chondrolysis of the Hip following Septic Arthritis: A Rare Complication of Magnetic Resonance Arthrography

Abstract

Magnetic resonance arthrography (MRA) is commonly used to detect labral tears of the hip. Complications of MRA are unusual and include minor reactions such as chemical synovitis and urticaria. This paper presents a rapidly progressive chondrolysis of the hip in a young patient after arthrography. The patient had suffered from acute septic arthritis and was treated by emergent arthroscopic surgery followed by appropriate antibiotics. At 18 months of followup, there were no signs of active infection but evidence of joint chondrolysis. Magnetic resonance arthrography (MRA) of the hip is an invasive procedure and should therefore be recommended judiciously. Post-MRA pain is common but often mild and temporary, while post-MRA joint infection is rare; nevertheless, severe joint pain and limitation should raise suspicion for septic hip.

Magnetic Resonance Imaging of the Postoperative Meniscus

“…In the United States, the intra-articular administration of gadolinium-based contrast agents is off-label (ie, not specifically approved by the US Food and Drug Administration [FDA]). [91][92][93][94][95] With MR arthrography, some tears do not fill with contrast material: the signal contacting the surface of a recurrent meniscus tear may be equal to or less than that of adjacent intra-articular gadolinium contrast material. 96 Of note, when conventional MR imaging findings are consistent with a meniscus retear, but contrast material does not extend into the meniscus on MR arthrography, a meniscus retear is likely (Fig.…”

MR Arthrography of the Shoulder: Technical Update and Clinical Applications

“…49 Intraarticular administration of gadolinium-based contrast agents has been associated with the development of chemical synovitis. 52 Individuals with an estimated glomerular filtration rate (eGFR) of 60 ml/min/1.73 m 2 are thought to be safe to be injected with gadolinium-based contrast agents; however, individuals with an eGFR < 30 ml/min/1.73 m 2 are thought to be at a higher risk for nephrogenic systemic fibrosis (NSF), 48 although there have been no reports of NSF resulting from intra-articular administration of gadolinium-based agents. 51 Intra-articular gadolinium passively diffuses from the glenohumeral joint into the bloodstream within 6 to 24 hours after it has been injected, and it is then excreted from the kidneys.…”