Imaging Services
MRI of the Hip
Basics: What is an MRI of the Hip?
Additional:
Pain in the hips is often difficult to assess with plain radiographs. Early avascular necrosis in patients of any age and fractures in patients with osteopenia are especially problematic. Avascular necrosis may not show significant radiographic changes until it has advanced. MRI is superior in early detection of avascular necrosis, enabling institution of appropriate therapy or intervention in predisposed patients to avert collapse and arthritic changes in the hip. In addition, if radiographic signs of avascular necrosis are demonstrated in one hip, the opposite hip should also be assessed for early signs of avascular necrosis.
Elderly patients who have osteoarthritic as well as osteoporotic changes in their hips may be difficult to assess for hip fractures. When plain radiographs show no apparent fracture, but physical examination findings strongly suggest one, MRI can more accurately assess these subtle occult fractures because it is very sensitive to marrow edema.
Magnetic Resonance Imaging is considered medically necessary for the evaluation of the hips or pelvic bones for the following indications:
- Suspected avascular necrosis, femoral head.
- Suspected intra or extra articular abnormality (e.g., loose body).
- Slipped femoral capital epiphesis and tears of the acetabular labrum.
Discussion of images above:
1. Severe reactive osteoarthritis of the right hip joint. Extensive marrow edema involves both the femoral head, neck and adjacent weight-bearing acetabulum. There is severe anterosuperior asymmetric joint space loss with superolateral migration of the femoral head. There is a large joint effusion with extensive synovial proliferation and multiple intra-articular loose bodies.
2. Mild greater trochanteric bursitis with mild insertional tendinosis of the gluteus medius at the greater trochanter.
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