title: Diagnostic performance of direct traction MR arthrography of the hip: detection of chondral and labral lesions with arthroscopic comparison.
abstract: OBJECTIVE
  To assess diagnostic performance of traction MR arthrography of the hip in detection and grading of chondral and labral lesions with arthroscopic comparison.
  
  
  METHODS
  Seventy-five MR arthrograms obtained ± traction of 73 consecutive patients (mean age, 34.5 years; range, 14-54 years) who underwent arthroscopy were included. Traction technique included weight-adapted traction (15-23 kg), a supporting plate for the contralateral leg, and intra-articular injection of 18-27 ml (local anaesthetic and contrast agent). Patients reported on neuropraxia and on pain. Two blinded readers independently assessed femoroacetabular cartilage and labrum lesions which were correlated with arthroscopy. Interobserver agreement was calculated using κ values. Joint distraction ± traction was evaluated in consensus.
  
  
  RESULTS
  No procedure had to be stopped. There were no cases of neuropraxia. Accuracy for detection of labral lesions was 92 %/93 %, 91 %/83 % for acetabular lesions, and 92 %/88 % for femoral cartilage lesions for reader 1/reader 2, respectively. Interobserver agreement was moderate (κ = 0.58) for grading of labrum lesions and substantial (κ = 0.7, κ = 0.68) for grading of acetabular and femoral cartilage lesions. Joint distraction was achieved in 72/75 and 14/75 hips with/without traction, respectively.
  
  
  CONCLUSIONS
  Traction MR arthrography safely enabled accurate detection and grading of labral and chondral lesions.
  
  
  CONCLUSIONS
  • The used traction technique was well tolerated by most patients. • The used traction technique almost consistently achieved separation of cartilage layers. • Traction MR arthrography enabled accurate detection of chondral and labral lesions.
authors.affiliation: Department of Radiology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria, florian.schmaranzer@student.i-med.ac.at.
authors.forename: Florian
authors.initials: F
authors.lastname: Schmaranzer
authors.forename: Andrea
authors.initials: A
authors.lastname: Klauser
authors.forename: Michael
authors.initials: M
authors.lastname: Kogler
authors.forename: Benjamin
authors.initials: B
authors.lastname: Henninger
authors.forename: Thomas
authors.initials: T
authors.lastname: Forstner
authors.forename: Markus
authors.initials: M
authors.lastname: Reichkendler
authors.forename: Ehrenfried
authors.initials: E
authors.lastname: Schmaranzer
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D002357:Cartilage Diseases / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014143:Traction / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media