Value of response to anesthetic injection during hip MR arthrography to differentiate between intra- and extra-articular pathology

Kheterpal, Arvin; Bunnell, Katherine M; Husseini, Jad S.; Chang, Connie Y.; Martin, Scott D.; Zoga, Adam C.; Bredella, Miriam A.

doi:10.1007/s00256-019-03323-9

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…As reported by Kheterpal et al. [ 29 ], the subject group would be stronger if a hip source of symptoms was proven with an anesthetic exam. However, the study included patients undergoing hip arthroscopic surgery, and all had acetabular labral tearing.…”

Section: Discussionmentioning

confidence: 84%

The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

Shimodaira

Hatakeyama

Suzuki

et al. 2021

Journal of Hip Preservation Surgery

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Femoroacetabular impingement syndrome (FAIS) has been associated with osteitis pubis; however, it is still unclear whether hip dysplasia is associated with osteitis pubis. This study aimed to investigate (i) the incidence of pubic bone marrow edema (BME) on magnetic resonance imaging in symptomatic patients with FAIS, borderline developmental dysplasia of the hip (BDDH) and developmental dysplasia of the hip (DDH) undergoing hip arthroscopic surgery with labral preservation and (ii) the demographic and radiographic factors associated with pubic BME. A total of 259 symptomatic patients undergoing hip arthroscopic surgery between July 2016 and April 2019 were retrospectively reviewed and divided into three groups: FAIS (180 patients), BDDH (29 patients) and DDH (50 patients). Diffuse changes in the pubic bone adjacent to the pubic symphysis were labeled pubic BME, and the prevalence of their occurrence was examined. Multivariate logistic regression analysis was performed to identify factors involved in pubic BME, and odds ratios (ORs) for relevant factors were calculated. There was no significant difference in the prevalence of pubic BME among the three groups (20 [11.1%] of 180 FAIS patients, 6 [20.6%] of 29 BDDH patients and 7 [14%] of 50 DDH patients, P = 0.325). Multivariate logistic regression analysis showed that acetabular coverage was not associated with pubic BME, whereas younger age and greater alpha angle were still independent associated factors [age ≤26 years (OR, 65.7) and alpha angle ≥73.5° (OR, 4.79)]. Determining the possible association of osteitis pubis with cam impingement in dysplastic hips may provide insights toward a more accurate understanding of its pathophysiology.

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Section: Discussionmentioning

confidence: 84%

The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

Shimodaira

Hatakeyama

Suzuki

et al. 2021

Journal of Hip Preservation Surgery

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“…Some practitioners include anesthetics in the injectate to provide comfort to the patient during image acquisition [ 43 , 44 ] or for diagnostic purposes [ 45 ], but a growing body of pre-clinical literature points to chondrotoxicity of local anesthetics [ 46 – 49 ]. Limiting intra-articular delivery with use of less chondrotoxic anesthetics (e.g., ropivacaine) may be warranted [ 46 ].…”

Section: Technical Considerationsmentioning

confidence: 99%

SSR white paper: guidelines for utilization and performance of direct MR arthrography

Chang,

Bencardino,

French

et al. 2023

Skeletal Radiol

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Objective Direct magnetic resonance arthrography (dMRA) is often considered the most accurate imaging modality for the evaluation of intra-articular structures, but utilization and performance vary widely without consensus. The purpose of this white paper is to develop consensus recommendations on behalf of the Society of Skeletal Radiology (SSR) based on published literature and expert opinion. Materials and methods The Standards and Guidelines Committee of the SSR identified guidelines for utilization and performance of dMRA as an important topic for study and invited all SSR members with expertise and interest to volunteer for the white paper panel. This panel was tasked with determining an outline, reviewing the relevant literature, preparing a written document summarizing the issues and controversies, and providing recommendations. Results Twelve SSR members with expertise in dMRA formed the ad hoc white paper authorship committee. The published literature on dMRA was reviewed and summarized, focusing on clinical indications, technical considerations, safety, imaging protocols, complications, controversies, and gaps in knowledge. Recommendations for the utilization and performance of dMRA in the shoulder, elbow, wrist, hip, knee, and ankle/foot regions were developed in group consensus. Conclusion Although direct MR arthrography has been previously used for a wide variety of clinical indications, the authorship panel recommends more selective application of this minimally invasive procedure. At present, direct MR arthrography remains an important procedure in the armamentarium of the musculoskeletal radiologist and is especially valuable when conventional MRI is indeterminant or results are discrepant with clinical evaluation.

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“…Response to an intra-articular anesthetic injection at the time of MR arthrography was shown to have a high positive predictive value for intra-articular pathology as a source of pain. 63 Treatment of FAI with osteochondroplasty remains a practice that varies with each individual surgeon. A recent randomized controlled trial on the treatment of FAI concluded that the main value of osteochondroplasty is the prevention of recurrent hip symptoms.…”

Section: Intra-articular: Labral Tears and Femoroacetabular Impingementmentioning

confidence: 99%

Imaging Review of Hockey-related Lower Extremity Injuries

Holmes

Yan

Mallinson

et al. 2022

Semin Musculoskelet Radiol

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Hockey is a fast-paced contact sport with a high incidence of injuries. Although injuries are more frequent among elite players, recreational hockey injuries are a common issue faced by primary care and emergency physicians. Lower extremity injuries in hockey are particularly important because they account for approximately a third of all injuries and > 60% of all overuse injuries. This pictorial review provides the general and specialty trained radiologist with a knowledge of the patterns of lower extremity injury that occur in ice hockey.

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Value of response to anesthetic injection during hip MR arthrography to differentiate between intra- and extra-articular pathology

Cited by 7 publications

References 25 publications

The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

SSR white paper: guidelines for utilization and performance of direct MR arthrography

Imaging Review of Hockey-related Lower Extremity Injuries

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