title: Imaging structural abnormalities in the hip joint: instability and impingement as a cause of osteoarthritis.
abstract: Osteoarthritis is thought to be caused by a combination of intrinsic vulnerabilities of the joint, such as anatomic shape and alignment, and environmental factors, such as body weight, injury, and overuse. It has been postulated that much of osteoarthritis is due to anatomic deformities. Advances in surgical techniques such as the periacetabular osteotomy, safe surgical dislocation of the hip, and hip arthroscopy have provided us with effective and safe tools to correct these anatomical problems. The limiting factor in treatment outcome in many mechanically compromised hips is the degree of cartilage damage which has occurred prior to treatment. In this regard, the role of imaging, utilizing plain radiographs in conjunction with magnetic resonance imaging, is becoming vitally important for the detection of these anatomic deformities and pre-radiographic arthritis. In this article, we will outline the plain radiographic features of hip deformities that can cause instability or impingement. Additionally, we will illustrate the use of MRI imaging to detect subtle anatomic abnormalities, as well as the use of biochemical imaging techniques such as dGEMRIC to guide clinical decision making.
authors.affiliation: Department of Orthopaedic Surgery, Children's Hospital-Boston, Harvard Medical School, Boston, Massachusetts 02115, USA. young-jo.kim@childrens.harvard.edu
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sarah
authors.initials: S
authors.lastname: Bixby
authors.forename: Tallal C
authors.initials: TC
authors.lastname: Mamisch
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.forename: Jack C
authors.initials: JC
authors.lastname: Carlisle
mesh_terms: D006621:Hip Joint / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography