title: Validation of a standardized mapping system of the hip joint for radial MRA sequencing.
abstract: OBJECTIVE
  Intraarticular gadolinium-enhanced magnetic resonance arthrography (MRA) is commonly applied to characterize morphological disorders of the hip. However, the reproducibility of retrieving anatomic landmarks on MRA scans and their correlation with intraarticular pathologies is unknown. A precise mapping system for the exact localization of hip pathomorphologies with radial MRA sequences is lacking. Therefore, the purpose of the study was the establishment and validation of a reproducible mapping system for radial sequences of hip MRA.
  
  
  METHODS
  Sixty-nine consecutive intraarticular gadolinium-enhanced hip MRAs were evaluated. Radial sequencing consisted of 14 cuts orientated along the axis of the femoral neck. Three orthopedic surgeons read the radial sequences independently. Each MRI was read twice with a minimum interval of 7 days from the first reading. The intra- and inter-observer reliability of the mapping procedure was determined.
  
  
  RESULTS
  A clockwise system for hip MRA was established. The teardrop figure served to determine the 6 o'clock position of the acetabulum; the center of the greater trochanter served to determine the 12 o'clock position of the femoral head-neck junction. The intra- and inter-observer ICCs to retrieve the correct 6/12 o'clock positions were 0.906-0.996 and 0.978-0.988, respectively.
  
  
  CONCLUSIONS
  The established mapping system for radial sequences of hip joint MRA is reproducible and easy to perform.
authors.affiliation: Department of Orthopedic Surgery, Inselspital, Bern University Hospital, 3010, Bern, Switzerland, frank.klenke@insel.ch.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Klenke
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Hoffmann
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Cross
authors.forename: Klaus A
authors.initials: KA
authors.lastname: Siebenrock
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000592:standards; D002648:Child; D005260:Female; D025981:Hip Injuries / Q000473:pathology*; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D007592:Joint Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards*; D008297:Male; D015588:Observer Variation; D056888:Patient Positioning / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013557:Switzerland; D055815:Young Adult