Diagnosis of the painful hip by magnetic resonance imaging and arthroscopy

Edwards, D.L.; Lomas, David J.; Villar, Richard

doi:10.1302/0301-620x.77b3.7744918

Cited by 129 publications

(59 citation statements)

References 16 publications

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“…The use of MRI, particularly with contrast, in the diagnosis of pathology such as labral tears is broadly accepted. However, the accuracy of MRI in detecting articular surface abnormalities is questionable [7,10,16], and diagnostic yield is poor in terms of evaluation of patients with chondral softening, fibrillation, or partial thickness defects of less than 1 cm [7]. MRI arthrography has increased the sensitivity and specificity of diagnosis of labral tears to 95% and 88%, respectively, but it has not had the same effect on the diagnosis of chondral lesions [5].…”

Section: Discussionmentioning

confidence: 99%

Chondral degeneration and therapeutic hip arthroscopy

Walton

Jahromi

Lewis

2004

International Orthopaedics (SICOT)

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Therapeutic hip arthroscopy for the treatment of chondral degeneration remains controversial. A retrospective cohort study examined 70 patients of mean age 47 (range 22-87) years who had undergone hip arthroscopy and assessed them for evidence of chondral degeneration using radiological and arthroscopic means. Clinical outcome was assessed using a modified Farjo and Glick classification. Thirty-nine patients had evidence of chondral degeneration on arthroscopy with or without radiological diagnosis, and 31 had alternative pathology. If patients were found to have chondral degeneration at arthroscopy, they were significantly more likely to have a poor clinical result than if an alternative diagnosis such as a loose body or labral tear was made (p<0.0001). Patients with evidence of degenerative changes on plain hip radiographs were significantly more likely to have a poor clinical result following hip arthroscopy than patients with unremarkable hip radiographs (p<0.0001). Therapeutic hip arthroscopy for osteoarthritis should be used with caution, as a poor clinical result is significantly more likely compared to other pathologies such as a labral tear or loose body.Résumé L'arthroscopie thérapeutique de la Hanche pour le traitement des chondropathies reste controversé. Une étude rétrospective d'une cohorte de 70 malades d'âge moyen 47 ans (22-87) qui avait subi arthroscopie de la hanche a été faite avec étude de la chondropathie à partir des données radiologiques et arthroscopiques. Le résultat clinique a été noté en utilisant une classification modifié de Farjo et Glick. Thirty-nine malades avaient une chondropathie arthroscopique, avec ou sans diagnostic radiologique, et 31 avaient une pathologie alternative. Si les malades avaient une chondropathie, ils avaient significativement un plus mauvais résultat clinique que s'ils avaient une autre pathologie, comme un corps étranger ou une déchirure du labrum (p<0.0001). Les patients avec des signes radiologiques dégénératifs avaient un plus mauvais résultat clinique que ceux avec une radiographie normale (p<0.0001). Les arthroscopies thérapeutiques pour arthrose devraient être utilisées avec prudence car le résultat cinique est moins bon que dans les autres pathologies comme les corps étrangers ou les déchirures du labrum.

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Section: Discussionmentioning

confidence: 99%

Chondral degeneration and therapeutic hip arthroscopy

Walton

Jahromi

Lewis

2004

International Orthopaedics (SICOT)

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“…Since the introduction of gadolinium magnetic resonance arthrography [22] and newer techniques such as radial imaging, magnetic resonance imaging (MRI) is now commonly used in the evaluation of the painful non-arthritic hip [7,30]. One example is its use in the assessment of femoroacetabular impingement [ 13,281 associated with the cam-effect.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement

Beaulé

Zaragoza²,

Motamedi³

et al. 2005

J. Orthop. Res.

295

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Femoroacetabular impingement secondary to the cam effect is thought to be associated with an insufficient anterior concavity in the sagittallaxial plane of the femoral head-neck junction. Using three-dimensional computed tomography the anterior and posterior concavity of the femoral head-neck junction was assessed in 36 painful non-dysplastic hips (30 patients). The mean age of the symptomatic hips was 40.7 with 13 females and 17 males. Eighteen out of the 36 hips had a pistol grip deformity. Magnetic resonance gadolinium arthrography was performed to assess for labral and cartilage lesions. Alpha and beta angles measuring the anterior and posterior femoral head-neck junction concavities were also determined in 20 asymptomatic hips (12 patients; mean age 37, 5 females and 7 males) using three-dimensional computed tomography. The mean alpha angle for the symptomatic and the control group were: 66.4 versus 43.8 0, = 0.001), and for the beta angle 40.2 versus 43.8 0, = 0.01 l), respectively. All but one of the symptomatic hips had a labral tear with 61% of these hips having associated cartilage damage. Three-dimensional computed tomography represents an accurate tool to quantify the femoral head-neck concavity providing a non-invasive assessment of hips at risk of femoroacetabular impingement.

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“…Encontraram também casos de falso-positivo para lesões labrais quando a imagem mostrava lesões próximas ao ligamento transverso (1) .…”

Section: Discussionunclassified

“…O reconhecimento de lesões intra-articulares do quadril, como motivo de dor e de futuras alterações de caráter degenerativo, tem levado os pesquisadores à procura de métodos diagnósticos de maior sensibilidade o mais precoce possível (1)(2)(3)(4)(5)(6)(7)(8)(9) .…”

Section: Introductionunclassified