The role of multidetector CT arthrography in the investigation of suspected intra-articular hip pathology

Abstract

ABSTRACT. The aim of this study was to evaluate the role of multidetector CT (MDCT) arthrography in the diagnosis of intra-articular hip pathology. A retrospective review of 96 patients who had undergone CT hip arthrography was performed. Data regarding the presence of a labral tear, paralabral cyst, chondral loss, acetabular version, femoral morphology and fibrocystic change were collected. We detected 28 labral tears (24 anterior, 2 anterolateral, 1 lateral and 1 posterolateral). An abnormal labral-chondral transitional zone was seen in 9 patients and 4 patients had surface labral fraying. We identified three paralabral cysts. Acetabular cartilage loss was detected in 45 and femoral cartilage loss in 9 patients. An abnormal anterior femoral head and neck junction was present in 18 hips and fibrocystic change in 8. Acetabular retroversion was present in 11 hips. 63 sets of patient notes were reviewed, of which 49 were in-patients with abnormal MDCT arthrogram findings. Surgical correlation was available in 27 patients. There was a discrepancy between the findings of a labral tear in one patient (false negative, 90% sensitivity and 100% specificity) and the presence of acetabular cartilage loss (88% sensitivity and 100% specificity) and femoral cartilage loss (94% sensitivity and 100% specificity) in three patients. MDCT arthrography affords accurate detection of intra-articular hip pathology. The investigation of suspected intra-articular hip pathology is challenging. Arthroscopy represents the gold standard but is invasive, necessitates a general anaesthetic and is best reserved for patients in whom concomitant therapeutic intervention is to be undertaken. Much of the radiology literature has focused on the use of MR arthrography of the hip to detect labral and cartilage pathology [1][2][3][4][5]. A number of groups have also studied the role of non-contrast MRI in the detection of labral tears associated with femoroacetabular impingement and acetabular dysplasia [6][7][8][9]. Both non-contrast MRI and MR arthrography have limitations in terms of spatial resolution, which can make the detection of subtle labral and cartilage pathology challenging [4].Modern spiral multidetector CT (MDCT) technology allows submillimetre spatial resolution and has revitalised interest in the role of CT arthrography in the wrist, shoulder, knee, elbow and ankle [10][11][12][13][14][15][16][17]. There are few published data on the utility of this technique in the investigation of intra-articular hip pathology. Several studies have investigated the ability of MDCT arthrography to assess cartilage loss in the hip and have demonstrated that its accuracy is equal to, or can outperform, MR arthrography [18][19][20]. There are limited reports regarding the ability of MDCT arthrography to assess labral pathology [9]. The aim of this study was to evaluate the role of MDCT arthrography in the diagnosis of intraarticular hip pathology in a consecutive group of patients. Methods and materialsA retrospective review of 96 consecutive patients ...

Correlation of Articular Cartilage Thickness Measurements Made With Magnetic Resonance Imaging, Magnetic Resonance Arthrography, and Computed Tomographic Arthrography With Gross Articular Cartilage Thickness in the Equine Metacarpophalangeal Joint

“…For evaluation of thin articular cartilage, such as that of the human hip, one study suggests that CTA may be superior to MRI, and may equal the accuracy of MRA . This is theorized to be due to the superior spatial resolution of CT relative to MRI . However, in this study, MRA was largely considered the best imaging modality for evaluation of internal hip joint pathology due to the ability to separate adjacent articular surfaces with the use of a diluted contrast medium and provide increased contrast between soft tissues, allowing more complete evaluation of the juxtaarticular structures .…”

Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know

“…This allows for better appreciation of labral abnormalities, cartilage lesions, and other intra-articular hip pathology. 41 Another recent novel use of CT arthrography is the ability to measure sulfated glycosaminoglycans (sGAG) content in vivo. A good correlation has been found between sGAG content measured using CT arthrogram in patients before total knee replacement versus micro-CT of the knee specimen at baseline.…”

Evaluation of Intra-Articular Hip Pathology: Comparison of CT Arthrography And MR Arthrography / Kalca Intraartikuler Patolojilerinin Degerlendirilmesinde BT Artrografisi ve MR Artrografisinin Karsilastirilmasi

“…Bilgisayarlı tomografi artrografisi (BTA) ise genellikle MR kontrendikasyonu gibi bazı özel durumlarda MRA'nın yedek sistemi olarak kulllanılmaktadır. Ancak son yıllarda bu konuda yapılan bazı araştırmalarla özellikle tetkik süresinin kısalığı, yüksek uzaysal rezolüsyonu ve submilimetrik skalada farklı düzlemlerde görüntü elde edilebilmesi gibi avantajları sayesinde BTA ön plana çıkmaya başlamıştır (3)(4)(5)(6)(7)(8)(9).…”