Imaging of the hip

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Imaging of the hip

C Fang, FRCS and J Teh, MRCP, FRCR

Department of Radiology, Nuffield Orthopaedic Centre NHS Trust, Windmill Road, Headington, Oxford OX3 7LD, UK

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Figure 1. Coronal T₁ weighted MR arthrogram demonstrating normal anatomy. The triangular shaped superior labrum (white arrow) and inferior labrum (black arrow) are surrounded by contrast and therefore well visualized. The transverse acetabular ligament (arrowheads) blends with the hip capsule.

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Figure 2. Axial oblique T₂ gradient echo MR arthrogram demonstrating the anterior and posterior portions of the acetabular labrum. Note that there is some heterogeneous signal within the intact labrum which may represent myxoid degeneration.

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Figure 3. Plain radiograph of a painful hip in a 40-year-old female on long term steroids showing some minor sclerosis of the femoral neck but no definite fracture.

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Figure 4. Same patient as Figure 3

. Coronal T₁ weighted image demonstrating a well defined subcapital low signal fracture line.

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Figure 5. Same patient as Figure 3

. Coronal short tau inversion recovery image demonstrating oedema surrounding the fracture.

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Figure 6. Ultrasound of the trochanteric region demonstrating distension of the trochanteric bursa consistent with bursitis.

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Figure 7. Coronal short tau inversion recovery image demonstrating high signal adjacent to the greater trochanter indicating trochanteric bursitis.

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Figure 8. Avascular necrosis of both hips. Coronal short tau inversion recovery image of both hips showing oedema in the left femoral head and neck, with some minor oedema in the right femoral head. There is subchondral low signal consistent with sclerosis. The oedema correlates with disease activity.

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Figure 9. Same patient as Figure 8

. Avascular necrosis of both hips. Coronal T₁ weighted image demonstrating loss of the normal marrow signal in both femoral heads which are both slightly flattened.

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Figure 10. Same patient as Figure 8

. Coronal T₂ weighted image demonstrating a geographical subchondral lesion with the classical "double line" sign (arrow) of avascular necrosis. The high signal line represents hypervascular tissue in the necrotic region surrounded by a fibrosed and sclerotic zone.

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Figure 11. Transient osteoporosis of both hips in a pregnant woman. Coronal short tau inversion recovery image demonstrating high signal in both femoral head and necks indicating bone marrow oedema.

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Figure 12. Same patient as Figure 11

. Coronal T₁ weighted image demonstrating normal configuration of both femoral heads with no evidence of any subchondral abnormality. The arrowhead points to the gravid uterus.

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Figure 13. Axial CT scan of an osteoid osteoma showing a small lucent nidus surrounded by cortical sclerosis.

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Figure 14. Same patient as Figure 13

. Coronal CT reformat demonstrating the extent of the osteoblastic reaction surrounding the lucent nidus.

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Figure 15. Osteoid osteoma. Coronal short tau inversion recovery image demonstrating a low signal nidus with surrounding high signal oedema.

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Figure 16. Coronal short tau inversion recovery image demonstrating an iliopsoas abscess (arrow) in association with a septic arthropathy of the left hip.

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Figure 17. Plain radiograph of the hip demonstrating multiple small ossified bodies in the hip joint in a patient with synovial osteochondromatosis.

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Figure 18. Coronal T₂ weighted image demonstrating multiple low signal loose bodies within the joint (arrowhead) adjacent to the zona obicularis (arrow).

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Figure 19. Pigmented villonuodular synovitis. Axial T₁ weighted image through both hips demonstrating low signal thickening of the synovium (arrows) indicating haemosiderin deposition.

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Figure 20. Pigmented villonodular synovitis. Axial T₂ weighted image through both hips demonstrating low signal thickening of the synovium (arrows) indicating haemosiderin deposition.

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Figure 21. Coronal gradient echo MR arthrogram demonstrating a normal rounded labrum. Compare with Figures 1 and 2

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Figure 22. Coronal T₁ weighted MR arthrogram demonstrating linear contrast (arrow) within the anterosuperior labrum indicating a tear.

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Figure 23. Coronal T₁ weighted MR arthrogram demonstrating labral detachment (arrow).

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Figure 24. Coronal gradient echo MR arthrogram demonstrating a paralabral cyst in a patient with a labral tear.

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Figure 25. Longitudinal ultrasound scan demonstrating a moderate hip joint effusion (arrows).

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Figure 26. Plain radiograph demonstrating a synovial herniation pit (Pitt's pit).

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Figure 27. Coronal short tau inversion recovery image demonstrating a small high signal focus in the femoral neck corresponding to a synovial herniation pit.