MR arthrography of the hip with and without leg traction: Assessing the diagnostic performance in detection of ligamentum teres lesions with arthroscopic correlation

Schmaranzer, Florian; Klauser, Andrea; Kogler, Michael; Henninger, Benjamin; Forstner, Thomas; Reichkendler, M.; Schmaranzer, Ehrenfried

doi:10.1016/j.ejrad.2015.11.027

Cited by 20 publications

(6 citation statements)

References 28 publications

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“…Initial results of traction MR arthrography of the hip showed high accuracy in detecting chondrolabral lesions, lesions of the ligamentum teres, and intra-articular loose bodies. [132][133][134][135] In our experience, traction is not only helpful in detecting cartilage delamination but also in visualizing the whole extent of cartilage damage in older patients with mild radiographic joint degeneration. In these patients the referring surgeons request advanced imaging with traction to determine whether a joint-preserving surgery is still a reasonable treatment option based on the already present cartilage degeneration (►Fig.…”

Section: Mri Protocolmentioning

confidence: 69%

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

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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Over the last 2 decades, the definition of pathomechanical concepts that link osseous deformities to chondrolabral damage and expose young and active patients to the risk of early osteoarthritis has led to a tremendous increase in the number of joint-preserving surgeries performed. The rise in arthroscopic procedures has led to an increasing demand for comprehensive preoperative magnetic resonance imaging (MRI) assessment of the hip joint. This includes conventional MRI for the assessment of extra-articular and periarticular pathologies such as greater trochanteric pain, deep gluteal pain syndrome, and sports injuries. Magnetic resonance arthrography with or without traction is reserved for the accurate evaluation of deformities associated with impingement and hip instability and for detecting the resulting intra-articular lesions. This article summarizes the current standard imaging techniques that the radiologist should know. It also explores the potential of computer-assisted analysis of three-dimensional MRI for virtual impingement simulation and volumetric analysis of cartilage composition and geometry.

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Section: Mri Protocolmentioning

confidence: 69%

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

Schmaranzer

Cerezal

Llopis

2019

Semin Musculoskelet Radiol

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“…MRI has been shown to have lower sensitivity and specificity in detecting partial LT tears compared with magnetic resonance arthrography (MRA) 21 . Based on arthroscopic correlation, Schmaranzer et al 22 found that MRA demonstrated 90% and 72% sensitivity with and without the use of hip traction. Cerezal et al 15 found a similar sensitivity (92%) with MRA and leg traction for complete LT tears, though the sensitivity of highgrade partial tears was only 66% in this study.…”

Section: Risk Factor Reference(s)mentioning

confidence: 99%

Ligamentum teres tendinopathy and tears

Kraeutler

Garabekyan

Pascual-Garrido

et al. 2019

Muscle Ligaments and Tendons J

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Background: The ligamentum teres (LT) consists of two bands that originate on the ischial and pubic sides of the acetabular notch and insert on the fovea capitis of the femoral head. Recent studies have established the LT as an important hip stabilizer in a squatting position, particularly in patients with osseous instability. Purpose: This review aims to concisely present the literature on LT tendinopathy and tears in order to guide health care professionals in the appropriate diagnosis and treatment of these disorders. Methods: We reviewed the literature on the diagnosis and surgical management of ligamentum teres tendinopathy and tears. Conclusions: The ligamentum teres is an important stabilizer to the hip joint, particularly with hip flexion and external rotation. Older age and acetabular bony pathomorphology are two of the known risk factors for LT tears. Symptoms of LT tendinopathy are largely non-specific, mimicking a wide range of other hip disorders including impingement and instability. Debridement of LT tears or reactive tissue has been reported with good outcomes, with more recent studies describing reconstruction of a completely torn, nonfunctional, or absent LT using various graft sources including synthetic grafts, autografts, and allografts. Level of evidence: II.

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“…Controversy exists in the usefulness of imaging for diagnosing LT pathology. [39][40][41] Magnetic resonance arthrogram (MRA) is thought to be more useful than conventional magnetic resonance imaging (MRI). 1,42 Studies have noted intact and partially LT tears can have similar imaging findings on MRA, making the diagnosis of partial LT tears difficult.…”

Section: Imagingmentioning

confidence: 99%

CLINICAL RELEVANCE of the LIGAMENTUM TERES: A LITERATURE REVIEW

Martin

McDonough

Enseki

et al. 2019

Intl J Sports Phys Ther

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Background: The ligamentum teres (LT) continues to be a structure of debate and interest. Previously thought of as a vestigial structure, an awareness of LT pathology and its potential importance has increased with the expansion of hip arthroscopy. Purpose: To provide a comprehensive literature synthesis on the LT and provide clinicians with the most current research regarding the LT and its anatomical features, functional relevance, prevalence of injury, risk factors for injury, clinical presentation, and treatment for pathology. Methods: A systematic literature search was conducted using Medline/PubMed, CINAHL/EBSCO, and Cochrane/ Wiley databases/platforms using the following search terms: ligament, ligament teres, hip, femur, femoral head, round ligament. Results: This search yielded 1284 articles of which 44 met the inclusion/exclusion criteria and contributed to this manuscript. Information on the LT was summarized into the following areas: anatomy, function, injury prevalence, risk factors, mechanism of injury, duration of symptoms, clinical presentation (symptoms, range of motion, functional limitations, special testing), imaging, and treatment. Conclusions: The results of this review supported the following: 1) the LT has a function in restraining hip rotation range of motion; 2) the prevalence of LT pathology in any given population may be largely dependent on the severity of bony deformity (either femoroacetabular impingement(FAI) or dyplasia) and activity level; 3) older age and acetabular bony deformity (either FAI or dyplasia) are risk factors for generalized LT pathology; 4) unique signs and symptoms are difficult to identify because LT pathology rarely occurs in isolation and is likely the end-stage consequence of other hip pathology; 5) the presence of LT pathology may negatively affect an individual's ability to function; and 6) surgical debridement is recommend for pain relief of partial LT tears with reconstruction possible for complete LT tears when complaints of instability are noted.

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MR arthrography of the hip with and without leg traction: Assessing the diagnostic performance in detection of ligamentum teres lesions with arthroscopic correlation

Cited by 20 publications

References 28 publications

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

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

Ligamentum teres tendinopathy and tears

CLINICAL RELEVANCE of the LIGAMENTUM TERES: A LITERATURE REVIEW

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