Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Schmaranzer, Florian; Cerezal, Luís; Llopis, Eva

doi:10.1055/s-0039-1678729

Cited by 12 publications

(6 citation statements)

References 145 publications

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“…After further 10 to 30 minutes MRI was performed with a standard, multiplanar protocol of 2D coronal-, sagittal-, radial proton-density (PD) weighted turbo spin echo images without fat saturation. 22 Sequence parameters for the 2D radial PD-weighted images were as follows: repetition time (TR)/echo time (TE) 1500 ms/18 ms, 4 mm slice thickness, 16 × 16 cm field of view, matrix size of 448 × 317, acquisition time (AT) of 4:30 minutes. 23 The dGEMRIC sequence was performed 45 to 70 minutes after injection of the contrast agent and included a standard dual-flip angle T1 volume interpolated breath-examination (VIBE) sequence 24 : TR/TE, 15 ms/3.3 ms, flip angles of 4° and 24°, slice thickness of 0.8 mm, 16 × 16 cm field of view, matrix size of 192 × 192, in-plane resolution of 0.83 × 0.83 mm interpolated to 0.4 × 0.4 mm, AT of 8.46 minutes for 128 slices.…”

Section: Methodsmentioning

confidence: 99%

Improved Cartilage Quality on Delayed Gadolinium-Enhanced MRI of Hip Cartilage after Subchondral Drilling of Acetabular Cartilage Flaps in Femoroacetabular Impingement Surgery at Minimum 5-Year Follow-Up

et al. 2020

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Objective To assess whether subchondral drilling of acetabular cartilage flaps during femoroacetabular impingement (FAI) surgery improves (1) acetabular dGEMRIC indices and (2) morphologic magnetic resonance imaging (MRI) scores, compared with hips in which no additional treatment of cartilage lesions had been performed; and (3) whether global dGEMRIC indices and MRI scores correlate. Design Prospective cohort study of consecutive patients with symptomatic FAI treated with open surgery between 2000 and 2007. Patients with subchondral drilling of acetabular cartilage flaps were allocated to the study group, those without drilling to the control group. All patients underwent indirect 3-T MR arthrography to assess cartilage quality by dGEMRIC indices and a semiquantitative morphologic MRI score at minimum 5 years after surgery. dGEMRIC indices and morphologic MRI scores were compared between and among groups using analysis of covariance/paired t tests. Results No significant difference was found between the global dGEMRIC indices of the study group (449 ± 147 ms, 95% CI 432-466 ms) and the control group (428 ± 143 ms, 95% CI 416-442 ms; P = 0.235). In regions with cartilage flaps, the study group showed higher dGEMRIC indices (472 ± 160 ms, 95% CI 433-510 ms) compared with the control group (390 ± 122 ms, 95% CI 367-413 ms; P < 0.001). No significant differences were found for the morphologic MRI scores. A strong inversely linear correlation between the dGEMRIC indices and the morphologic MRI scores ( r = −0.727, P < 0.001) was observed. Conclusions Treatment of acetabular cartilage flaps with subchondral drilling leads to better cartilage quality in regions with cartilage flaps at minimum 5 years of follow-up.

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Section: Methodsmentioning

confidence: 99%

Improved Cartilage Quality on Delayed Gadolinium-Enhanced MRI of Hip Cartilage after Subchondral Drilling of Acetabular Cartilage Flaps in Femoroacetabular Impingement Surgery at Minimum 5-Year Follow-Up

et al. 2020

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“…Radial MRI scan sections can depict a cam morphology circumferentially at the femoral head-neck junction, which conventional radiographs in two planes may miss and underestimate [10,11,20,39,47]. Thus, radial MRI scans seem to be the more accurate method for depicting a cam morphology.…”

Section: Limitationsmentioning

confidence: 99%

“…For this reason, we designed a prospective, longitudinal MRI study to monitor morphological changes during growth. Noncontrast MRI scans with radial cuts on the proximal femur have the advantage that they can detect the morphology in a more three-dimensional (3-D) way and the lesions can be detected more easily than on plain radiographs [20,39,47]. In addition, MRI can differentiate open from closed physes [13,38] and can detect alterations in the shape of the physeal scar at the area of the cam morphologies [41,44].…”

Section: Introductionmentioning

confidence: 99%

A Cam Morphology Develops in the Early Phase of the Final Growth Spurt in Adolescent Ice Hockey Players: Results of a Prospective MRI-based Study

Hanke

Schmaranzer

Steppacher

et al. 2021

Clin Orthop Relat Res

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Background Cam morphologies seem to develop with an increased prevalence in adolescent boys performing high-impact sports. The crucial question is at what age the cam morphology actually develops and whether there is an association with an aberration of the shape of the growth plate at the cam morphology site. Questions/purposes (1) What is the frequency of cam morphologies in adolescent ice hockey players, and when do they appear? (2) Is there an association between an extension of the physeal growth plate and the development of a cam morphology? (3) How often do these players demonstrate clinical findings like pain and lack of internal rotation? Methods A prospective, longitudinal MRI study was done to monitor the proximal femoral development and to define the appearance of cam morphologies in adolescent ice hockey players during the final growth spurt. Young ice hockey players from the local boys’ league up to the age of 13 years (mean age 12 ± 0.5 years) were invited to participate. From 35 players performing on the highest national level, 25 boys and their parents consented to participate. None of these 25 players had to be excluded for known disease or previous surgery or hip trauma. At baseline examination as well as 1.5 and 3 years later, we performed a prospective noncontrast MRI scan and a clinical examination. The three-dimensional morphology of the proximal femur was assessed by one of the authors using radial images of the hip in a clockwise manner. The two validated parameters were: (1) the alpha angle for head asphericity (abnormal > 60°) and (2) the epiphyseal extension for detecting an abnormality in the shape of the capital physis and a potential correlation at the site of the cam morphology. The clinical examination was performed by one of the authors evaluating (1) internal rotation in 90° of hip and knee flexion and (2) hip pain during the anterior impingement test. Results Cam morphologies were most apparent at the 1.5-year follow-up interval (10 of 25; baseline versus 1.5-year follow-up: p = 0.007) and a few more occurred between 1.5 and 3 years (12 of 23; 1.5-year versus 3-year follow-up: p = 0.14). At 3-year follow-up, there was a positive correlation between increased epiphyseal extension and a high alpha angle at the anterosuperior quadrant (1 o’clock to 3 o’clock) (Spearman correlation coefficient = 0.341; p < 0.003). The prevalence of pain on the impingement test and/or restricted internal rotation less than 20° increased most between 1.5-year (1 of 25) and the 3-year follow-up (6 of 22; 1.5-year versus 3-year follow-up: p = 0.02). Conclusion Our data suggest that a cam morphology develops early during the final growth spurt of the femoral head in adolescent ice hockey players predominantly between 13 to 16 years of age. A correlation between an increased extension of the growth plate and an increased alpha angle at the site of the cam morphology suggests a potential underlying growth disturbance. This should be further followed by high-resolution or biochemical MRI methods. Considering the high number of cam morphologies that correlated with abnormal clinical findings, we propose that adolescents performing high-impact sports should be screened for signs of cam impingement, such as by asking about hip pain and/or examining the patient for limited internal hip rotation. Level of Evidence Level I, prognostic study.

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“…Dabei gehört die MRT der Hüfte zur Standardabklärung bei der gelenkserhaltenden Chirurgie. Die radiäre Bildgebung zur zirkumferenziellen und orthogonalen Darstellung der ossären Morphologie des Kopf-Hals-Überganges sowie von Labrum und Knorpel ist essenziell für die Beurteilung [18]. Die Verwendung von intraartikulärem Kontrastmittel hat sich als deutlich vorteilhaft bei der Detektion von Knorpel-und Labrumdefekten gezeigt [18].…”

Section: Zusatzaufnahmenunclassified

Therapieentscheidung bei Kombinationspathologien Dysplasie – FAI – Fehlrotation

et al. 2022

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Zusammenfassung Hintergrund Dysplasie, FAI und femorale Fehlrotationen treten häufig gemeinsam auf und führen zu einem Mischbild an Symptomen und biomechanischen Einschränkungen der Hüfte. Fragestellung Was sind die aktuellen Empfehlungen zur bestmöglichen Diagnostik und Therapie bei Kombinationspathologien in der hüfterhaltenden Chirurgie. Methoden Auswertung und Diskussion der relevanten Literatur mit Berücksichtigung der eigenen Erfahrung in der Behandlung von komplexen kombinierten Pathomorphologien der Hüfte. Ergebnisse Die Anamnese und klinische Untersuchung sind richtungsweisend zur Bestimmung der für die Beschwerden ursächlichen Pathomorphologien. Ein korrekt zentriertes Beckenübersichtsbild sowie eine axiale Aufnahme der Hüfte ist die Grundlage der radiologischen Beurteilung der Hüfte, je nach Fall ergänzt mit MRT, CT sowie Animationen der Hüfte. Da sich die Pathologien funktionell gegenseitig beeinflussen, wird in der Behandlung ein schrittweises Vorgehen empfohlen mit vorerst Korrektur der funktionell relevantesten Pathologie, gefolgt von weiteren Korrekturen je nach Bedarf. Erreicht werden muss vornehmlich eine stabile, korrekt überdachte Hüfte, gefolgt von einem normalen Impingement-freien Bewegungsumfang und normalisierter Funktion der Muskulatur. Dabei ist bei der Wahl der Operationsmethode darauf zu achten, dass sämtliche Pathologien suffizient behandelt werden können. Schlussfolgerung Mittels der Operationstechniken der hüfterhaltenden Chirurgie können komplexe, kombinierte Pathologien der Hüfte suffizient behandelt werden. Wichtig ist eine gründliche Diagnostik, um die unterschiedlichen Pathologien und deren Zusammenspiel zu erkennen. Das Ziel der operativen Therapie ist eine möglichst korrekt überdachte, stabile Hüfte mit normalem Bewegungsumfang.

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Conventional and Arthrographic Magnetic Resonance Techniques for Hip Evaluation: What the Radiologist Should Know

Cited by 12 publications

References 145 publications

Improved Cartilage Quality on Delayed Gadolinium-Enhanced MRI of Hip Cartilage after Subchondral Drilling of Acetabular Cartilage Flaps in Femoroacetabular Impingement Surgery at Minimum 5-Year Follow-Up

Improved Cartilage Quality on Delayed Gadolinium-Enhanced MRI of Hip Cartilage after Subchondral Drilling of Acetabular Cartilage Flaps in Femoroacetabular Impingement Surgery at Minimum 5-Year Follow-Up

A Cam Morphology Develops in the Early Phase of the Final Growth Spurt in Adolescent Ice Hockey Players: Results of a Prospective MRI-based Study

Therapieentscheidung bei Kombinationspathologien Dysplasie – FAI – Fehlrotation

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