Current concepts in magnetic resonance imaging of the adult hip and pelvis

Transient osteoporosis of the hip in a non-pregnant woman

“…Two-thirds of the cases of transient osteoporosis of the hip occur in healthy middle-aged men between the ages of 40 and 60 years, and one-third in women who are in the third trimester of pregnancy 1 2. The hip joint is the most commonly affected are in transient osteoporosis, but it can also affect the knee, foot and ankle 3. Differential diagnoses such as AVN, septic arthritis, malignancies, inflammatory joint diseases and fractures of the femoral neck, as well as RSD and pigmented villonodular synovitis, should be taken into consideration 5.…”

“…Transient osteoporosis of the hip is a self-limiting condition, but avascular necrosis of the hip is a progressive condition leading to collapse of the femoral head. In transient osteoporosis of the hip and avascular necrosis of the hip, a plain radiograph shows changes in 3–8 weeks after the onset of symptoms 3. In transient osteoporosis of the hip there is diffuse homogeneous involvement of the proximal femur (head–neck) and sometimes it extends up to the intertrochanteric region, acetabulum, iliac wings and ischiopubic rami; but there is always normal joint space with no osseous erosion or subchondral collapse 3 6.…”

“…In transient osteoporosis of the hip and avascular necrosis of the hip, a plain radiograph shows changes in 3–8 weeks after the onset of symptoms 3. In transient osteoporosis of the hip there is diffuse homogeneous involvement of the proximal femur (head–neck) and sometimes it extends up to the intertrochanteric region, acetabulum, iliac wings and ischiopubic rami; but there is always normal joint space with no osseous erosion or subchondral collapse 3 6. In AVN, the involvement is focal and non-homogeneous, with subchondral collapse and decreased joint space in advance conditions.…”

“…X-ray changes showing demineralisation of femoral head and neck may not be seen until as long as 6 weeks after the onset of symptoms. MRI shows bone marrow oedema and is highly sensitive for diagnosis of the disorder 3. Other conditions that can mimic it on MRI are osteonecrosis, osteomyelitis and neoplasms 4 5.…”

MR Evaluation of Non-Traumatic Hip Pain

“…It provides excellent soft tissue resolution, multiplanar imaging and is without the risk of ionizing radiation. MRI is the modality of choice for imaging a vascular necrosis, radiographically occult fractures, marrow replacement disorders, musculoskeletal neoplasms, and various arthritides involving the hip joint [2].…”