title: Clinical and surgical correlation of hip MR arthrographic findings in adolescents.
abstract: OBJECTIVE
  The purpose of this study was to analyze the utility of MRA-H in adolescents by comparing the results of imaging with surgical findings and/or clinical outcome.
  
  
  METHODS
  After obtaining appropriate IRB approval, the Radiologic Information System database was queried for all patients 13-18 years of age who underwent MRA-H from 2004 through 2013. The electronic medical record was reviewed for clinical history, clinical examination findings, and operative notes. MRA-H images were reviewed for soft tissue abnormalities (labral tear, paralabral ganglion, articular cartilage loss, synovitis, ligament tears) and bony abnormalities (cam-type femoroacetabular impingement (FAI), pincer-type FAI, hip dysplasia). MRA-H findings were correlated with surgical findings and with clinical outcomes.
  
  
  RESULTS
  Twenty-six patients with labral tears by MRA-H were included in study and grouped as follows: Group I) patients who underwent surgical management (n=10); group II) patients managed non-surgically (medication, intra-articular injection, physical therapy) (n=9); group III) patients lost to follow up after being advised to have surgery (n=7). With regard to presenting symptomatology, 87.5% of patients with labral tear had groin pain. Of those patients who were diagnosed with a labral tear, 52% were categorized as idiopathic labral tears, 26% as secondary tears (secondary to abnormal bony morphology), and 22% as traumatic labral tears. The labral tears were found to be anterior in 61% and posterior in 22%. Associated articular cartilage lesions were found in 29% of patients. In group I (surgical patients), MRA-H labral findings were confirmed at surgery in 9/10. Seventy percent of labral tears in our study had some form of abnormal bony morphology. Nine of the 12 patients with bone abnormalities were derived from group I patients. Six out of 7 patients with cam-type FAI had a labral tear.
  
  
  CONCLUSIONS
  Labral tears diagnosed by MRA-H in the adolescent population correlated well with clinical examination and surgical findings. Also, MRA-H contributed by defining bony morphology that was directly applied to surgical management. Non-surgical management of labral tears diagnosed on MRA-H had a generally favorable outcome.
authors.affiliation: Department of Radiology, Loyola University Medical Center, 2160, South 1st Avenue, Maywood, Illinois, 60153, United States. Electronic address: anugayathri.jawahar@lumc.edu.
authors.forename: Anugayathri
authors.initials: A
authors.lastname: Jawahar
authors.affiliation: Department of Radiology, Loyola University Medical Center, 2160, South 1st Avenue, Maywood, Illinois, 60153, United States.
authors.forename: Aruna
authors.initials: A
authors.lastname: Vade
authors.affiliation: Department of Radiology, Loyola University Medical Center, 2160, South 1st Avenue, Maywood, Illinois, 60153, United States.
authors.forename: Laurie
authors.initials: L
authors.lastname: Lomasney
authors.affiliation: Department of Radiology, Loyola University Medical Center, 2160, South 1st Avenue, Maywood, Illinois, 60153, United States.
authors.forename: Gokcan
authors.initials: G
authors.lastname: Okur
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160, South 1st Avenue, Maywood, Illinois, 60153, United States.
authors.forename: Douglas
authors.initials: D
authors.lastname: Evans
authors.affiliation: Department of Mathematics and Statistics, Oakland University, Rochester, MI, 48309, United States.
authors.forename: Perla
authors.initials: P
authors.lastname: Subbaiah
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D000293:Adolescent; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007089:Image Enhancement; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Adolescent; Follow up; MR hip arthrogram; Surgery; Symptoms; Treatment