Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging.
OBJECTIVE
Traditional imaging techniques have limited ability to detect subtle chondral and labral injuries of the hip. We performed a retrospective review of patients who underwent magnetic resonance imaging (MRI) of the hip and subsequent hip arthroscopy in order to evaluate the ability of optimized, noncontrast MRI to identify tears of the acetabular labrum and defects in articular cartilage.


METHODS
Retrospective review of a consecutive sample.


METHODS
Between January 1997 and July 2000, 92 patients had MRI of the hip, followed by arthroscopic surgery of that hip by 1 of 2 surgeons (R.B., D.E.P.). Two musculoskeletal MR radiologists blinded to the initial MRI and surgical findings, independently interpreted the studies, looking for the location and degree of articular cartilage and acetabular labral pathology.


RESULTS
Of the 92 patients studied, each of 2 radiologists correctly identified 83 (94%) and 84 (95%) of the 88 labral tears present at surgery, respectively. There was 92% interobserver agreement on the MRI studies. For articular cartilage defects on the femoral head and acetabulum, there was good agreement (92% and 86% within 1 grade) between MRI and surgical grading and between the 2 MR readers (kappa of 0.8 for femoral head cartilage and 0.7 for acetabular cartilage).


CONCLUSIONS
This study shows that noncontrast MRI of the hip, using an optimized protocol, can noninvasively identify labral and chondral pathology. Such information may facilitate deciding which patients warrant surgical intervention, thus preserving hip arthroscopy as a therapeutic tool.


METHODS
Level II, Development of Diagnostic Criteria Study.
Mintz
Douglas N
DN
Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York 10021, USA.
Hooper
Timothy
T
Connell
David
D
Buly
Robert
R
Padgett
Douglas E
DE
Potter
Hollis G
HG
D000077:Acetabulum / Q000293:injuries / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D002356:Cartilage / Q000293:injuries / Q000473:pathology*; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology*; D003238:Connective Tissue / Q000293:injuries / Q000473:pathology; D005260:Female; D006621:Hip Joint / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity