title: Magnetic resonance arthrography of the hip: prevalence of diagnoses not suspected by the referring physician and correlation with clinical examination and pain score.
abstract: BACKGROUND
  Magnetic resonance arthrography (MRA) of the hip is the most sensitive imaging modality for intra-articular pathologies such as labral tears.
  
  
  OBJECTIVE
  To evaluate the prevalence of non-suspected pathologies revealed by hip MRA and correlate them to physical examination/pain level.
  
  
  METHODS
  All hip MRAs (2011-2013) were retrospectively evaluated for intra- and extra-articular pathologies in consensus by two readers. A clinical score (0-7)/pain score (0-10) was calculated for each patient based on orthopedic test results extracted from referral forms/a telephone questionnaire. Patients were divided into four groups according to MRA findings: intra-articular expected (targeted) pathology only; intra-articular targeted and additional non-targeted (unexpected) pathology; non-targeted pathology; and no pathology. Pathologies prevalence/clinical score/pain score were compared between the groups.
  
  
  RESULTS
  A total of 229 MRAs were included (127 men, 102 women; mean age, 36.5 ± 14.17 years): 111(48.4%) patients had solely intra-articular targeted pathology. Significant non-targeted pathologies were detected in 76 (33%) patients (targeted and non-targeted, 51; non-targeted only 25). No significant pathology was detected in 42 patients (18%). Mean physical examination score was 2.77 ± 1.77, range 0-7. There was no significant difference or correlation (r = 0.017, P = 0.804) between the clinical scores of the different MRA pathology groups. Pain score (143 patients) was significantly higher in the non-targeted pathology group compared to the targeted and non-targeted group (P = 0.04) and to the no pathology group (P = 0.04). There was no correlation between the physical examination score and the pain score (r = 0.017, P = 0.804).
  
  
  CONCLUSIONS
  Unsuspected non-targeted pathologies were detected in 33% of hip MRA. Physical examination/pain level could not differentiate between patients.
authors.affiliation: Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel.
authors.forename: Maor
authors.initials: M
authors.lastname: Neiman
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Osnat
authors.initials: O
authors.lastname: Halshtok Neiman
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Dvora
authors.initials: D
authors.lastname: Aharoni
authors.affiliation: Department of Orthopedic Surgery, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Boaz
authors.initials: B
authors.lastname: Liberman
authors.affiliation: Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel.
authors.forename: Eliyahu
authors.initials: E
authors.lastname: Adar
authors.affiliation: Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel iriseshed@gmail.com.
authors.forename: Iris
authors.initials: I
authors.lastname: Eshed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010808:Physical Examination; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D003287:Contrast Media
keywords: Magnetic resonance imaging (MRI); arthrography; hip; unsuspected diagnoses