title: Hip joint pathology: clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases.
abstract: BACKGROUND
  The hip joint is becoming increasingly recognized as a source of groin pain and, in the authors' experience, buttock and low back pain.
  
  
  OBJECTIVE
  To determine the range of pathologic diagnoses, clinical presentation, and the correlation between magnetic resonance arthrographic, ultrasonographic, and arthroscopic findings in the hip joint.
  
  
  METHODS
  We prospectively studied 25 consecutive hip arthroscopies to determine the range of pathologic diagnoses, clinical presentation, and the correlation between magnetic resonance arthrographic, ultrasonographic, and arthroscopic findings.
  
  
  RESULTS
  All of the hips arthroscoped had pathology. Back pain and hip pain were the 2 most common presentations. The only consistently positive clinical test result was a restricted and painful hip quadrant compared with the contralateral hip. Of the 17 patients whose flexion, abduction, external rotation (FABER) test results were reported at the time of examination, 15 (88%) were positive, and 2 (12%) negative. Plain radiographs were normal in all patients. All but 1 patient underwent magnetic resonance arthrography. Although specificity of 100% was achieved in our study, the sensitivity was significantly lower, with a relatively high number of false negatives. Hip arthroscopy proved the definitive diagnostic procedure for intraarticular pathology.
  
  
  CONCLUSIONS
  Hip pathology, particularly labral pathology, may be more common than has been previously recognized. In those patients with chronic groin and low back pain, a high index of suspicion should be maintained. Clinical signs of a painful, restricted hip quadrant and a positive FABER test result should suggest magnetic resonance arthrography in the first instance, but a negative magnetic resonance image should not preclude hip arthroscopy if there is high clinical suspicion of hip joint pathology.
authors.affiliation: Olympic Park Sports Medicine Centre, Melbourne, Australia. opsmc@opsmc.com.au
authors.forename: Bruce
authors.initials: B
authors.lastname: Mitchell
authors.forename: Paul
authors.initials: P
authors.lastname: McCrory
authors.forename: Peter
authors.initials: P
authors.lastname: Brukner
authors.forename: John
authors.initials: J
authors.lastname: O'Donnell
authors.forename: Emma
authors.initials: E
authors.lastname: Colson
authors.forename: Robert
authors.initials: R
authors.lastname: Howells
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D001265:Athletic Injuries / Q000175:diagnosis / Q000601:surgery; D005260:Female; D025981:Hip Injuries / Q000175:diagnosis* / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography