Emerging topics on the hip: Ligamentum teres and hip microinstability

Cerezal, Luís; Arnáiz, Javier; Canga, Ana; Piedra, Tatiana; Altónaga, José R.; Munafo, Ricardo M.; Pérez-Carro, Luís

doi:10.1016/j.ejrad.2011.04.001

Cited by 70 publications

(56 citation statements)

References 41 publications

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“…On MR images, a thickened iliofemoral ligament (anterior joint capsule) with irregularities on the undersurface of the anterior capsule has been described as a sign correlating with clinical findings of laxity (130). However, a contradicting study reports an anterior capsular thinning in hip laxity (2.5 mm with laxity versus 3.3 mm without laxity) (132).…”

Section: State Of the Art: Hip Imaging In Athletesmentioning

confidence: 82%

“…In a lax hip during motion, the joint and its surrounding soft tissues are suspected to not be capable of keeping the femoral head centered in the acetabulum (130). The concept of microinstability is based on symptomatic hip laxity, but without complete luxation or marked subluxation (130). Origin of microinstability is believed to be either traumatic (single or repetitive trauma) or atraumatic (generalized laxity or developmental dysplasia of the hip).…”

Section: Concept and Controversiesmentioning

confidence: 99%

“…The surrounding soft tissues such as the labrum, joint capsule, ligaments, and muscles are important static and dynamic hip stabilizers in sports (130). In a lax hip during motion, the joint and its surrounding soft tissues are suspected to not be capable of keeping the femoral head centered in the acetabulum (130). The concept of microinstability is based on symptomatic hip laxity, but without complete luxation or marked subluxation (130).…”

Section: Concept and Controversiesmentioning

confidence: 99%

“…The clinical diagnosis is difficult, as there are no clear criteria for hip microinstability (52). Patients may feel "instability" in the hip joint, snapping, and/or pain during sports (130). If conservative treatment fails, hip arthroscopy may be performed by some surgeons to reduce capsule volume (131).…”

Section: Concept and Controversiesmentioning

confidence: 99%

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Hip Imaging in Athletes: Sports Imaging Series

et al. 2016

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Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam-and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam-and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. After reading the article and taking the test, the reader will be able to:n Describe biomechanical implications of torsional malalignment and other atypical forms of hip impingement n Describe the most common MR imaging findings in femoroacetabular impingement and identify anatomic variants n Describe imaging characteristics of a Morel-Lavallée lesion and identify the anatomic compartment where this lesion typically occurs n Identify common stress fractures around the hip joint in athletes and discuss potential complications n Describe features of myotendinous injuries around the hip n Describe the anatomic relationship of the sacrotuberous ligament and the origin of the hamstring tendons n Describe the anatomic structures involved in an athletic pubalgia Accreditation and Designation Statement The RSNA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The RSNA designates this journal-based SA-CME activity for a maximum of 1.0 AMA PRA Category 1 Credit ™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure StatementThe ACCME requires that the RSNA, as an accredited prov...

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Section: State Of the Art: Hip Imaging In Athletesmentioning

confidence: 82%

Section: Concept and Controversiesmentioning

confidence: 99%

Section: Concept and Controversiesmentioning

confidence: 99%

Section: Concept and Controversiesmentioning

confidence: 99%

See 2 more Smart Citations

Hip Imaging in Athletes: Sports Imaging Series

et al. 2016

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“…Teitz [25] supported this finding by describing microtrauma to the labrum associated with extreme ranges of external rotation. Capsular microtrauma and ligamentum teres injuries may be caused by repeated external rotation and axial loading, creating microinstability in the hip joint [26]. Bauman et al [27] theorized that dancers may have dysplastic acetabulae, allowing for the great ranges of motion required.…”

Section: Hip Dysplasia and Pathomechanicsmentioning

confidence: 99%

Hip dysplasia and the performing arts: is there a correlation?

Turner

O’Sullivan

Edelstein

2012

Curr Rev Musculoskelet Med

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Dancers frequently present with hip pain. The etiology of this pathology has not been clearly identified from an anatomical perspective. Structural variations including hip dysplasia and dynamic variables from the foot to the pelvis will be discussed. Understanding the etiology as a structural entity, neuromuscular entity or a combination of the two, allows for a successful rehabilitative process and a successful return to dance. This article describes the possible correlation between hip dysplasia and hip pain in the dancer, the relationship of dance postures to the kinematic chain and outlines possible treatment strategies for management.

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Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function

2015

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The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed. A total of 69 references were obtained, that included 53 full text articles, three published abstracts, and 13 textbooks. Many publications related to clinical studies (n = 11) rather than gross anatomy (n = 7), with one report on variation of the LHF. Considerable inconsistency in the naming and description of the LHF morphology was observed. Variable attachment sites were reported except for the acetabular notch, transverse acetabular ligament, and the femoral fovea. Presence and patency of the ligamental arteries supplying the head of the femur and their exact location were variably described and were often incomplete. The LHF is believed to be taught in extreme hip adduction, but there is little evidence to support this. In conclusions, further investigation of the anatomy of the LHF is recommended, particularly to clarify its mechanical role, innervation, and vascular contribution to the developing and adult femur, so to better inform clinical practice.

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Emerging topics on the hip: Ligamentum teres and hip microinstability

Cited by 70 publications

References 41 publications

Hip Imaging in Athletes: Sports Imaging Series

Hip Imaging in Athletes: Sports Imaging Series

Hip dysplasia and the performing arts: is there a correlation?

Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function

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