1
|
Automated 3D Analysis of Clinical Magnetic Resonance Images Demonstrates Significant Reductions in Cam Morphology Following Arthroscopic Intervention in Contrast to Physiotherapy. Arthrosc Sports Med Rehabil 2022; 4:e1353-e1362. [PMID: 36033193 PMCID: PMC9402425 DOI: 10.1016/j.asmr.2022.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To obtain automated measurements of cam volume, surface area, and height from baseline (preintervention) and 12-month magnetic resonance (MR) images acquired from male and female patients allocated to physiotherapy (PT) or arthroscopic surgery (AS) management for femoroacetabular impingement (FAI) in the Australian FASHIoN trial. Methods An automated segmentation pipeline (CamMorph) was used to obtain cam morphology data from three-dimensional (3D) MR hip examinations in FAI patients classified with mild, moderate, or major cam volumes. Pairwise comparisons between baseline and 12-month cam volume, surface area, and height data were performed within the PT and AS patient groups using paired t-tests or Wilcoxon signed-rank tests. Results A total of 43 patients were included with 15 PT patients (9 males, 6 females) and 28 AS patients (18 males, 10 females) for premanagement and postmanagement cam morphology assessments. Within the PT male and female patient groups, there were no significant differences between baseline and 12-month mean cam volume (male: 1269 vs 1288 mm3, t[16] = −0.39; female: 545 vs 550 mm,3t[10] = −0.78), surface area (male: 1525 vs 1491 mm2, t[16] = 0.92; female: 885 vs 925 mm,2t[10] = −0.78), maximum height (male: 4.36 vs 4.32 mm, t[16] = 0.34; female: 3.05 vs 2.96 mm, t[10] = 1.05) and average height (male: 2.18 vs 2.18 mm, t[16] = 0.22; female: 1.4 vs 1.43 mm, t[10] = −0.38). In contrast, within the AS male and female patient groups, there were significant differences between baseline and 12-month cam volume (male: 1343 vs 718 mm3, W = 0.0; female: 499 vs 240 mm3, t[18] = 2.89), surface area (male: 1520 vs 1031 mm2, t(34) = 6.48; female: 782 vs 483 mm2, t(18) = 3.02), maximum-height (male: 4.3 vs 3.42 mm, W = 13.5; female: 2.85 vs 2.24 mm, t(18) = 3.04) and average height (male: 2.17 vs 1.52 mm, W = 3.0; female: 1.4 vs 0.94 mm, W = 3.0). In AS patients, 3D bone models provided good visualization of cam bone mass removal postostectomy. Conclusions Automated measurement of cam morphology from baseline (preintervention) and 12-month MR images demonstrated that the cam volume, surface area, maximum-height, and average height were significantly smaller in AS patients following ostectomy, whereas there were no significant differences in these cam measures in PT patients from the Australian FASHIoN study. Level of Evidence Level II, cohort study.
Collapse
|
2
|
Bugeja JM, Chandra SS, Neubert A, Fripp J, Lockard CA, Ho CP, Crozier S, Engstrom C. Automated analysis of immediate reliability of T2 and T2* relaxation times of hip joint cartilage from 3 T MR examinations. Magn Reson Imaging 2021; 82:42-54. [PMID: 34147595 DOI: 10.1016/j.mri.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/31/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Magnetic resonance (MR) T2 and T2* mapping sequences allow in vivo quantification of biochemical characteristics within joint cartilage of relevance to clinical assessment of conditions such as hip osteoarthritis (OA). PURPOSE To evaluate an automated immediate reliability analysis of T2 and T2* mapping from MR examinations of hip joint cartilage using a bone and cartilage segmentation pipeline based around focused shape modelling. STUDY TYPE Technical validation. SUBJECTS 17 asymptomatic volunteers (M: F 7:10, aged 22-47 years, mass 50-90 kg, height 163-189 cm) underwent unilateral hip joint MR examinations. Automated analysis of cartilage T2 and T2* data immediate reliability was evaluated in 9 subjects (M: F 4: 5) for each sequence. FIELD STRENGTH/SEQUENCE A 3 T MR system with a body matrix flex-coil was used to acquire images with the following sequences: T2 weighted 3D-trueFast Imaging with Steady-State Precession (water excitation; 10.18 ms repetition time (TR); 4.3 ms echo time (TE); Voxel Size (VS): 0.625 × 0.625 × 0.65 mm; 160 mm field of view (FOV); Flip Angle (FA): 30 degrees; Pixel Bandwidth (PB): 140 Hz/pixel); a multi-echo spin echo (MESE) T2 mapping sequence (TR/TE: 2080/18-90 ms (5 echoes); VS: 4 × 0.78 × 0.78 mm; FOV: 200 mm; FA: 180 degrees; PB: 230 Hz/pixel) and a MESE T2* mapping sequence (TR/TE: 873/3.82-19.1 ms (5 echoes); VS: 3 × 0.625 × 0.625 mm; FOV: 160 mm; FA: 25 degrees; PB: 250 Hz/pixel). ASSESSMENT Automated cartilage segmentation and quantitative analysis provided T2 and T2* data from test-retest MR examinations to assess immediate reliability. STATISTICAL TESTS Coefficient of variation (CV) and intraclass correlations (ICC2, 1) to analyse automated T2 and T2* mapping reliability focusing on the clinically important superior cartilage regions of the hip joint. RESULTS Comparisons between test-retest T2 and (T2*) data revealed mean CV's of 3.385% (1.25%), mean ICC2, 1's of 0.871 (0.984) and median mean differences of -1.139ms (+0.195ms). CONCLUSION The T2 and T2* times from automated analyses of hip cartilage from test-retest MR examinations had high (T2) and excellent (T2*) immediate reliability.
Collapse
Affiliation(s)
- Jessica M Bugeja
- School of Information Technology and Electrical Engineering, The University of Queensland, Australia; Australian e-Health Research Centre, CSIRO, Australia.
| | - Shekhar S Chandra
- School of Information Technology and Electrical Engineering, The University of Queensland, Australia.
| | - Aleš Neubert
- School of Information Technology and Electrical Engineering, The University of Queensland, Australia; Australian e-Health Research Centre, CSIRO, Australia.
| | - Jurgen Fripp
- Australian e-Health Research Centre, CSIRO, Australia.
| | - Carly A Lockard
- Imaging Research Department, Steadman Philippon Research Institute, USA.
| | - Charles P Ho
- Imaging Research Department, Steadman Philippon Research Institute, USA.
| | - Stuart Crozier
- School of Information Technology and Electrical Engineering, The University of Queensland, Australia.
| | - Craig Engstrom
- School of Human Movement Studies, The University of Queensland, Australia.
| |
Collapse
|
3
|
Gao G, Wu R, Liu R, Wang J, Ao Y, Xu Y. Genes associated with inflammation and bone remodeling are highly expressed in the bone of patients with the early-stage cam-type femoroacetabular impingement. J Orthop Surg Res 2021; 16:348. [PMID: 34051794 PMCID: PMC8164327 DOI: 10.1186/s13018-021-02499-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Recent studies have shown high expression levels of certain inflammatory, anabolic, and catabolic genes in the articular cartilage from the impingement zone of the hips with femoroacetabular impingement (FAI), representing an increased metabolic state. Nevertheless, little is known about the molecular properties of bone tissue from the impingement zone of hips with FAI. METHODS Bone tissue samples from patients with early-stage cam-type FAI were collected during hip arthroscopy for treatment of cam-type FAI. Control bone tissue samples were collected from six patients who underwent total hip replacement because of a femoral neck fracture. Quantitative real-time polymerase chain reaction (PCR) was performed to determine the gene expression associated with inflammation and bone remodeling. The differences in the gene expression in bone tissues from the patients with early-stage cam-type FAI were also evaluated based on clinical parameters. RESULTS In all, 12 patients with early-stage cam-type FAI and six patients in the control group were included in this study. Compared to the control samples, the bone tissue samples from patients with FAI showed higher expression levels of interleukin-6 (IL-6), alkaline phosphatase (ALP), receptor activator of nuclear factor-kB ligand (RANKL), and osteoprotegerin (OPG) (P < 0.05). IL-1 expression was detected only in the control group. On the other hand, there was no significant difference in IL-8 expression between the patients with FAI and the control group. The patients with FAI having a body mass index (BMI) of >24 kg/m2 showed higher ALP expression (P < 0.05). Further, the expression of IL-6 and ALP was higher in the patients with FAI in whom the lateral center-edge angle was >30° (P < 0.05). CONCLUSIONS Our results indicated the metabolic condition of bone tissues in patients with early-stage cam-type FAI differed from that of normal bone in the femoral head-neck junction. The expression levels of the genes associated with inflammation and bone remodeling were higher in the bone tissue of patients with early-stage cam-type FAI than in the patients with normal bone tissue.
Collapse
Affiliation(s)
- Guanying Gao
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Ruiqi Wu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Rongge Liu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Jianquan Wang
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yingfang Ao
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yan Xu
- Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
| |
Collapse
|
4
|
Haneda M, Rai MF, O’Keefe RJ, Brophy RH, Clohisy JC, Pascual-Garrido C. Inflammatory Response of Articular Cartilage to Femoroacetabular Impingement in the Hip. Am J Sports Med 2020; 48:1647-1656. [PMID: 32383968 PMCID: PMC8906442 DOI: 10.1177/0363546520918804] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Femoroacetabular impingement (FAI) has been proposed as an etiologic factor in up to 50% of hips with osteoarthritis (OA). Inflammation is thought to be one of the main initiators of OA, yet little is known about the origin of intra-articular inflammation in FAI hips. HYPOTHESIS Articular cartilage from the impingement zone of patients with FAI has high levels of inflammation, reflecting initial inflammatory process in the hip. STUDY DESIGN Controlled laboratory study. METHODS Head-neck cartilage samples were obtained from patients with cam FAI (cam FAI, early FAI; n = 15), advanced OA secondary to cam FAI (FAI OA, late FAI; n = 15), and advanced OA secondary to developmental dysplasia of the hip (DDH OA, no impingement; n = 15). Cartilage procured from young adult donors (n = 7) served as control. Safranin O-stained sections were assessed for cartilage abnormality. Tissue viability was detected by TUNEL assay. Immunostaining of interleukin 1β (IL-1β), catabolic markers (matrix metalloproteinase 13 [MMP-13], a disintegrin and metalloproteinase with thrombospondin motif 4 [ADAMTS-4], aggrecan antibody to C-terminal neoepitope [NITEGE]), and an anabolic marker (type II collagen [COL2]) was performed to evaluate molecular inflammation and metabolic activity. The average percentage of immunopositive cells from the total cell count was calculated. Kruskal-Wallis test followed by Steel-Dwass post hoc test was used for multiple comparisons. RESULTS Microscopic osteoarthritic changes were more prevalent in cartilage of cam FAI and FAI OA groups compared with DDH OA and control groups. Cartilage in cam FAI and FAI OA groups, versus the DDH group, had higher expression of inflammatory molecules IL-1β (69.7% ± 18.1% and 72.5% ± 13.2% vs 32.7% ± 14.4%, respectively), MMP-13 (79.6% ± 12.6% and 71.4% ± 18.8% vs 38. 5% ± 13.3%), ADAMTS-4 (83.9% ± 12.2% and 82.6% ± 12.5% vs 45.7% ± 15.5%), and COL2 (93.6% ± 3.9% and 92.5% ± 5.8% vs 53.3% ± 21.0%) (P < .001). Expression of NITEGE was similar among groups (cam FAI, 89.7% ± 7.7%; FAI OA, 95.7% ± 4.7%; DDH OA, 93.9% ± 5.2%; P = .0742). The control group had minimal expression of inflammatory markers. Inflammatory markers were expressed in all cartilage zones of early and late FAI but only in the superficial zone of the no impingement group. CONCLUSION Cartilage from the impingement zone in FAI is associated with a high expression of inflammatory markers, extending throughout all cartilage zones. CLINICAL RELEVANCE Inflammation associated with FAI likely has a deleterious effect on joint homeostasis. Further clinical and translational studies are warranted to assess whether and how surgical treatment of FAI reduces molecular inflammation.
Collapse
Affiliation(s)
- Masahiko Haneda
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA
| | - Muhammad Farooq Rai
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA,Department of Cell Biology and Physiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Regis J. O’Keefe
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA
| | - Robert H. Brophy
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA
| | - John C. Clohisy
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA
| | - Cecilia Pascual-Garrido
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, Washington University School of Medicine, St Louis, Missouri, USA,Address correspondence to Cecilia Pascual-Garrido, MD, PhD, Washington University School of Medicine, Department of Orthopaedic Surgery, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA ()
| |
Collapse
|
5
|
Chahla J, Beck EC, Okoroha K, Cancienne JM, Kunze KN, Nho SJ. Prevalence and Clinical Implications of Chondral Injuries After Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome. Am J Sports Med 2019; 47:2626-2635. [PMID: 31411901 DOI: 10.1177/0363546519865912] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies on the effect of partial- and full-thickness chondral damage of the hip on outcomes and the ability to achieve meaningful clinical outcomes are limited. PURPOSE To determine the effect of full- and partial-thickness chondral injuries on 2-year outcomes in patients undergoing hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) compared with patients without chondral damage, and to identify significant predictors of achieving the patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID). STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Data from consecutive patients with evidence of chondromalacia at the time of primary hip arthroscopic surgery with routine capsular closure for the treatment of FAIS by a single fellowship-trained surgeon between January 2012 and September 2016 were reviewed. Patients were divided into groups with partial-thickness (grade I-III) or full-thickness (grade IV) chondral defects and matched by age and body mass index (BMI) to patients without chondral injuries. Preoperative and postoperative outcomes were compared among the 3 groups, and a binary logistic regression analysis was utilized to identify significant predictors of achieving the MCID and PASS. RESULTS There were 634 patients included in the analysis, with a mean age of 34.5 ± 10.9 years and a mean BMI of 25.2 ± 4.7 kg/m2. A total of 493 (77.8%) patients had no evidence of chondral damage, 92 (14.5%) patients had partial-thickness chondral defects, and 49 (7.7%) patients had full-thickness chondral defects. There were statistically significant differences in the Hip Outcome Score (HOS)-Activities of Daily Living, HOS-Sports Subscale, modified Harris Hip Score, pain, and satisfaction (P < .01) among the 3 groups. Patients with grade IV chondromalacia experienced the poorest outcomes and lowest percentage of achieving the PASS. Predictors for achieving any PASS threshold included preoperative alpha angle (odds ratio [OR], 0.96; P = .016), absence of preoperative limping (OR, 7.25; P = .002), absence of preoperative chronic pain (OR, 5.83; P = .019), primary hip arthroscopic surgery (OR, 0.17; P = .050), patients who self-identified as runners (OR, 2.27; P = .037), and Tönnis grade 0 (OR, 2.86; P = .032). Male sex (OR, 2.49; P = .015) was the only predictor of achieving any MCID threshold. CONCLUSION Patients with grade IV chondral defects experienced worse functional outcomes, lower satisfaction, and increased pain when compared with both patients without chondral damage or grade I-III chondromalacia at 2-year follow-up. Several predictors were associated with achieving clinically significant function in patients undergoing hip arthroscopic surgery for FAIS.
Collapse
Affiliation(s)
- Jorge Chahla
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Edward C Beck
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Kelechi Okoroha
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Jourdan M Cancienne
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Kyle N Kunze
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Shane J Nho
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
6
|
CORR Insights®: Do dGEMRIC and T2 Imaging Correlate With Histologic Cartilage Degeneration in an Experimental Ovine FAI Model? Clin Orthop Relat Res 2019; 477:1004-1006. [PMID: 30801288 PMCID: PMC6494300 DOI: 10.1097/corr.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
7
|
Do dGEMRIC and T2 Imaging Correlate With Histologic Cartilage Degeneration in an Experimental Ovine FAI Model? Clin Orthop Relat Res 2019; 477:990-1003. [PMID: 30507833 PMCID: PMC6494333 DOI: 10.1097/corr.0000000000000593] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Biochemical MRI of hip cartilage such as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping is increasingly used to judge cartilage quality in the assessment of femoroacetabular impingement (FAI). The current evidence is sparse about which of these techniques yields a stronger correlation with histologic cartilage degeneration because of the difficulty in validating biochemical MRI techniques against histology in the clinical setting. Recently, an experimental ovine FAI model was established that induces chondrolabral damage and offers a validated platform to address these limitations. QUESTIONS/PURPOSES In a sheep model, we asked: (1) Do dGEMRIC and/or T2 values of acetabular and femoral cartilage correlate with histologic cartilage degeneration as assessed with the Mankin score? (2) Do simultaneously measured dGEMRIC and T2 values correlate in an experimental ovine FAI model? METHODS We performed an experimental pilot study on five female Swiss Alpine sheep (10 hips) that underwent postmortem MRI, including biochemical cartilage sequences, after a staged FAI correction had been performed on one side. No surgery was performed on the contralateral side, which served as a healthy control. In these sheep, an extraarticular intertrochanteric varus osteotomy was performed to rotate the naturally aspherical ovine femoral head into the acetabulum to induce cam-type FAI and chondrolabral damage comparable to human beings. After a 70-day ambulation period, femoral osteochondroplasty was performed and all sheep were euthanized after a total observation period of 210 days. Before they were euthanized, the sheep received a contrast agent and roamed and walked for at least 45 minutes. Hips were prepared to fit in a knee coil and MRI was performed at 3 T including a three-dimensional (3-D) dGEMRIC sequence, a two-dimensional (2-D) radial T2 mapping sequence, and a 2-D radial proton density-weighted sequence for morphologic cartilage assessment. Using specifically developed software, the 3-D dGEMRIC images and T2 maps were coregistered on the 2-D morphologic radial images. This enabled us to simultaneously measure dGEMRIC and T2 values using the identical regions of interest. dGEMRIC and T2 values of the acetabular and femoral cartilage were measured circumferentially using anatomic landmarks. After MRI, bone-cartilage samples were taken from the acetabulum and the femur and stained with toluidine blue for assessment of the histologic cartilage degeneration using the Mankin score, which was assessed in consensus by two observers. Spearman's rank correlation coefficient was used to (1) correlate dGEMRIC values and T2 values with the histologic Mankin score of femoroacetabular cartilage; and to (2) correlate dGEMRIC values and T2 values of femoroacetabular cartilage. RESULTS A moderate to fair correlation between overall dGEMRIC values of the acetabular cartilage (R = -0.430; p = 0.003) and the femoral cartilage (R = -0.334; p = 0.003) versus the histologic Mankin score was found. A moderate correlation (R = -0.515; p = 0.010) was found among peripheral dGEMRIC values of the acetabulum, the superior femoral cartilage (R = -0.500; p = 0.034), and the histologic Mankin score, respectively. No correlation between overall and regional femoroacetabular T2 values and the histologic Mankin scores was found. No correlation between overall and regional femoroacetabular dGEMRIC values and T2 values was found. CONCLUSIONS In this recently established sheep model, we found dGEMRIC values correlated well with histologic evidence of cartilage degeneration in the hip. This combination of a robust animal model and an accurate imaging technique appears to offer a noninvasive means to study the natural course of FAI and to compare the effectiveness of potential surgical options to treat it. CLINICAL RELEVANCE This translational study supports the continuing use of dGEMRIC as a biomarker for prearthritic cartilage degeneration with the ultimate goal to identify patients who will benefit most from corrective FAI surgery. The value of T2 imaging of hip cartilage warrants further investigation.
Collapse
|
8
|
Geeslin AG, Geeslin MG, Chahla J, Mannava S, Frangiamore S, Philippon MJ. Comprehensive Clinical Evaluation of Femoroacetabular Impingement: Part 3, Magnetic Resonance Imaging. Arthrosc Tech 2017; 6:e2011-e2018. [PMID: 29399469 PMCID: PMC5794495 DOI: 10.1016/j.eats.2017.06.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/29/2017] [Indexed: 02/03/2023] Open
Abstract
Radiologic imaging is an essential supplement to the physical examination in the evaluation of a patient with femoroacetabular impingement. Plain radiographs are the initial modality of choice for the evaluation of bony anatomy and pathology. Magnetic resonance imaging supplements the physical examination and standard radiographs by enabling qualitative and quantitative evaluation of both articular cartilage and soft tissues about the hip. Magnetic resonance imaging also provides improved 3-dimensional characterization of the bony anatomy owing to the multiplanar nature of this technique. This article describes a comprehensive approach to interpretation of magnetic resonance examination of the hip.
Collapse
Affiliation(s)
| | - Matthew G. Geeslin
- University of Virginia School of Medicine, Charlottesville, Virginia, U.S.A
| | - Jorge Chahla
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | - Sandeep Mannava
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
| | | | - Marc J. Philippon
- Steadman Philippon Research Institute, Vail, Colorado, U.S.A
- The Steadman Clinic, Vail, Colorado, U.S.A
| |
Collapse
|