MRI of the Hip: What the Surgeon Wants to Know

Abstract

The purpose of this review is to explore novel MR imaging techniques focused on the hip as well as specific MR imaging findings of interest to the referring orthopedic surgeon. MR arthrography demonstrates high accuracy for the detection of chondrolabral lesions, which portend less favorable prognosis and may change surgical approach. The addition of leg traction has been shown to increase the accuracy of MR arthrography in detecting intra-articular pathology. 3D models of the hip generated from 3D imaging sequences can also be used for pre-surgical planning, including simulation of preoperative range of motion. Extra-articular pathology, including hamstring, gluteal, and iliopsoas tendon pathology can necessitate surgical intervention depending on the degree of injury. MR arthrography remains the imaging modality of choice in assessment of the hip when intra-articular pathology is clinically suspected, though conventional MR imaging at 3.0 T also demonstrates strong diagnostic performance. New techniques including direct traction and 3D imaging can provide valuable diagnostic and pre-surgical information in the assessment of the athlete’s hip.