Magnetic resonance imaging features of hip disorders in an Egyptian pediatric population

Abstract

Hip disorders in a pediatric population are a diagnostic challenge. The aim of the study is to assess the role of magnetic resonance imaging (MRI) in the evaluation of non-traumatic hip disorders in a series of Egyptian patients and to review the literature on the most common hip conditions. Seventy two consecutive patients [40 males (55.6%) and 32 females (44.4)] with acute onset of hip complaints unrelated to trauma or falls were recruited. All patients underwent an initial full clinical assessment and blood tests as well as contrast enhanced MRI of both hips. The most common diagnosis in this group of Egyptian patients was transient synovitis in 29 (40.3%) cases, followed by seronegative enthesopathy and arthropathy syndrome in 8 (11.1%), septic arthritis in 10 (13.9%), tuberculous arthritis in 4 (5.6%), sickle-cell disease in 7 (9.7%), complicated with septic arthritis in 3 (4.2%), transient bone marrow microenvironment (BME) in 3 (4.2%), osteomyelitis in 2 (2.8%), osteosarcoma in 2 (2.8%), sciatic nerve injury in 1 (1.4%), leukemia with BME in 1 (1.4%), coxa vara of both hips and L5/S1 facet joint ankylosis in 1 (1.4%), and a benign bone cyst in 1 (1.4%). MRI studies showed hip effusion in a total of 51 patients (70.8%), joint space narrowing in 9 (12.5%), and BME in 15(20.8%). MRI is a sensitive tool for assessing hip disorders in a pediatric population and can play an important role in both diagnosis and management of different hip disorders, irrespective of the underlying pathology.

Transient regional osteoporosis of the ankle with shifting bone marrow edema pattern within the joint

“…Bone marrow edema (BME) is a radiological term that describes a region that has low signal intensity on T1-weighted MRI but high signal intensity on T2 MRI or in short tau inversion recovery sequences [ 1 , 2 ]. BME affecting the hip joint(s) is neither a specific MRI finding nor a specific diagnosis [1] .…”

“…BME affecting the hip joint(s) is neither a specific MRI finding nor a specific diagnosis [1] . BME can be found in both adult and pediatric populations, with various underlying etiologies such as inflammatory arthropathy, transient osteoporosis of the hip (TOH), avascular necrosis, acute stress fractures, primary bone neoplasms, myeloproliferative bone marrow disorders like leukemia and hemoglobinopathies [ 1 , 2 ].…”

Transient regional osteoporosis of the hip with extensive bone marrow edema (BME): Dramatic improvement after three months of Alendronate therapy

“…Bone marrow edema (BME) is a radiological term describing a region with low signal intensity on T1 -weighted magnetic resonance imaging (MRI) but with high signal intensity on T2 MRI or in short tau inversion recovery sequences [ 1 , 2 ]. BME affecting the hip joint(s) is neither a specific MRI finding nor a specific diagnosis [1] .…”

“…BME affecting the hip joint(s) is neither a specific MRI finding nor a specific diagnosis [1] . In the hip joint, BME can be encountered in diverse hip disorders in both adult and pediatric populations with different underlying etiologies like inflammatory arthropathy, transient osteoporosis of the hip (TOH), avascular necrosis (AVN), acute stress fractures, primary bone neoplasms (eg, osteoid osteoma), myeloproliferative bone marrow disorders (eg, leukemia), hemoglobinopathy (eg, sickle cell crisis), and infection (eg, septic and tuberculous osteomyelitis [ 1 , 2 ].…”

Simultaneous multi-slice MR imaging of the hip at 3 T to reduce acquisition times and maintain image quality

“…In order to facilitate initial treatments, cartilage, labrum, ligament, and tendon diseases need to be precisely diagnosed in the early stages using MRI [2]. MRI plays an important role in decision making for surgical treatments, the alleviation of symptoms, and improved prognoses [3, 4].…”