Predictive Value of 3-T Magnetic Resonance Imaging in Diagnosing Grade 3 and 4 Chondral Lesions in the Hip

Ho, Charles P.; Ommen, N. Dawn; Bhatia, Sanjeev; Saroki, Adriana J.; Goljan, Peter; Philippon, Marc J.

doi:10.1016/j.arthro.2016.03.014

Cited by 18 publications

(12 citation statements)

References 28 publications

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“…Labral degeneration, labral lesions, and chondral lesions are generally well detected on MRA. 24 25 26 27 28 In a meta-analysis conducted by Smith et al, 24 16 studies on MRA of the hip were evaluated demonstrating sensitivity of 87% and specificity of 64% in the detection of labral tears. Such value of specificity was quite similar to that reported in this study, confirming its good capacity in excluding labral tears.…”

Section: Discussionmentioning

confidence: 99%

“…There is not a univocal interpretation regarding the detection of chondral lesions. Ho et al 26 considered MRA useful to detect high-grade chondral lesions, while Mintz et al also reported a good evaluation of grade-2 lesions. 27 In other studies, the exact grade of chondral damage has not clearly specified, thus making data interpretation rather difficult.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Accuracy of Magnetic Resonance Arthrography in Detecting Intra-articular Pathology Associated with Femoroacetabular Impingement

Carulli

Tonelli

Melani

et al. 2018

Joints

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Purpose The aim of this study was to assess the diagnostic accuracy of magnetic resonance arthrography (MRA) in the detection of intra-articular lesions of the hip in patients affected by femoroacetabular impingement (FAI) by using arthroscopy as reference standard. Methods Twenty-nine consecutive hip arthroscopies performed in 24 patients were considered for the study. Patients had a mean age of 38.3 years. Ultrasound-guided 1.5-T MRA was performed with precontrast short tau inversion recovery, T1-weighted and PD coronal, T1-weighted, and T2-weighted axial with 3-mm-thick slice sequences, and postcontrast T1-weighted fat saturation MRA (Fat-SAT) axial, coronal and oblique sagittal, and T1-weighted Vibe 3D coronal sequences with MPR sagittal, axial, and radial reconstructions with 2-mm-thick slice and coronal density protonil (DP) Fat-SAT. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRA were evaluated by comparison arthroscopy for the following intra-articular findings: acetabular and femoral chondral lesions, labral degeneration, labral tears, synovitis, ligamentum teres (LT) tears, CAM lesions, pincer lesions, loose bodies, and osteophytes. Results An absolute per cent agreement (100%) was observed for all the variables in the assessment of CAM lesions. Sensitivity, specificity, PPV, and NPV of MRA were 100, 68.4, 72.7, and 100%, respectively, for acetabular chondral lesions; 100, 50, 47.3, and 100%, respectively, for femoral chondral lesions; 33, 85, 20, and 91.6%, respectively, for labral tears; 95, 71, 91.3, and 83.3%, respectively, for labral degeneration; 100, 88, 57.1, and 100%, respectively, for LT tears; 33.3, 85, 50, and 73.9%, respectively, for pincer lesions; 50, 96, 66.6, and 92.3%, respectively, for intra-articular loose bodies; and 100, 73.9, 50, and 100%, respectively, for osteophytes. Conclusion MRA may play an important role in detecting intra-articular lesions associated with FAI. This might be helpful for the preoperative planning before hip arthroscopy. Level of Evidence This is a Level 2, diagnostic accuracy study compared with gold standard.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Magnetic Resonance Arthrography in Detecting Intra-articular Pathology Associated with Femoroacetabular Impingement

Carulli

Tonelli

Melani

et al. 2018

Joints

View full text Add to dashboard Cite

show abstract

“…Several studies have corroborated this finding, reporting the limited sensitivity of magnetic resonance imaging (MRI) in identifying chondral injuries of the hip. 7,8 With this in mind, I read with great interest the article titled, "Predicting Severe Cartilage Damage in the Hip: A Model Using Patient-Specific Data From 2396 Hip Arthroscopies," by Utsunomiya, Briggs, Dornan, Locks, Bolia, and Philippon. 9 In this study, the authors reviewed a cohort of >2,300 cases of hip arthroscopy, identifying those with highgrade cartilage injuries of the acetabulum or femoral head that were revealed during arthroscopy.…”

Section: See Related Article On Page 2051mentioning

confidence: 99%

Editorial Commentary: Predictive Nomograms for Hip Chondral Lesions: A Poor Man's Magnetic Resonance Imaging?

Degen¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Large systematic reviews have concluded that MRA is more accurate than MRI . Recent research suggests optimally performed conventional MRI at 3‐T field strengths and with improved surface coil technology can yield similar results to MRA at 1.5‐T . Computer Tomography (CT) is particularly useful for the assessment of previous bony surgery, AIIS morphology and periarticular fractures.…”

Section: Imaging Of the Post‐operative Hipmentioning

confidence: 99%

Persistent or recurrent symptoms after arthroscopic surgery for femoroacetabular impingement: A review of imaging findings

Woodward

Philippon

2018

J Med Imag Rad Onc

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Hip arthroscopy is one of the most rapidly growing and evolving orthopaedic subspecialties. With the recent dramatic increase in the volume of hip arthroscopy performed there has been an increase in the number of symptomatic patients following arthroscopy for femoroacetabular impingement. Imaging has a key role in determining the need for revision surgery and in preoperative planning. Although the revision rate for hip arthroscopy is 3-9%, little has been published about the imaging findings associated with unsatisfactory treatment outcomes. This review discusses the significance of pre-existing osteoarthritis and underlying hip dysplasia and describes the causes of persistent symptoms. Recent literature on extra articular impingement and causes of microinstability are presented. Post-operative appearances are described focussing on the clinically relevant imaging findings. The challenges of evaluating the labrum after repair and specific findings associated with anchor failure and iatrogenic chondrolabral injury are discussed. The purpose of this article is to review the causes of unsatisfactory treatment outcomes after hip arthroscopy, role of imaging and indications for revision arthroscopy.

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Predictive Value of 3-T Magnetic Resonance Imaging in Diagnosing Grade 3 and 4 Chondral Lesions in the Hip

Cited by 18 publications

References 28 publications

Diagnostic Accuracy of Magnetic Resonance Arthrography in Detecting Intra-articular Pathology Associated with Femoroacetabular Impingement

Diagnostic Accuracy of Magnetic Resonance Arthrography in Detecting Intra-articular Pathology Associated with Femoroacetabular Impingement

Editorial Commentary: Predictive Nomograms for Hip Chondral Lesions: A Poor Man's Magnetic Resonance Imaging?

Persistent or recurrent symptoms after arthroscopic surgery for femoroacetabular impingement: A review of imaging findings

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