Correlation of hip arthroscopy findings and different MRI techniques. A review of 99 cases

Abstract

MR arthrography has been claimed to have a very high sensitivity and specificity for diagnosing intraarticular hip joint pathology. This claim has not been supported by clinical experience in Australia. (Mitchell et al 03) In an attempt to improve the performance of MRI, 2 new techniques were developed. This paper compares the 2 new techniques and traditional MR arthrography to hip arthroscopic findings. Further, intra and intertester reliability studies were completed for the new technique. These results are presented. Methodology: Details of patients who had undergone hip arthroscopy in the last 4 years were kept by the author. Those who were still contactable and signed consent forms were included in the study. The MRI and operative reports were compared. 3 different MRI techniques were used over this period of time. MR arthrography, FSE PD spins in traditional planes and FSE PD spins with a new plane at a right angle to the plane of the acetabulum. Results: Radial tears of the labrum were the best detected pathology overall, with 54% deected overall. Synovitis, however, (present in 48% of hips) was only detected 4% of the time. All 11 flap labral tears were missed.: For detecting pathology on the edge of the hip joint, MR arthrography had. a sensitivity of 45%, PD FSE in traditional planes 67% and the new technique with cuts in the plane of the hip joint had a sensitivity of 86%. Conclusion: MR arthrography is not as accurate as previously thought. PD FSE MR appears to have a far superior sensitivity.