1

Unlock Your Glutes

Getting Powerful Shapely Glutes

Get Instant Access

Fig. 22. Synovial osteochondromatosis. Coronal T1, fat-suppressed MR arthrogram demonstrates multiple cartilaginous, intra-articular loose bodies consistent with synovial osteochon-dromatosis.

What Arthrogram

Fig. 23. Pigmented villonodular synovitis (PVNS). (A) Coronal T2-weighted image demonstrates low signal hyperplastic synovium filling the joint space laterally (arrow). This mass has resulted in lateral femoral neck osseous erosion (curved arrow). (B) Oblique sagittal T1, fat-suppressed MR arthrogram image. In the joint space anterior to the femoral neck there is massive proliferation of the synovium (arrow), which obliterates the joint recess. This mass shows low signal intensity characteristic of hemosiderin-laden synovium of PVNS.

Fig. 23. Pigmented villonodular synovitis (PVNS). (A) Coronal T2-weighted image demonstrates low signal hyperplastic synovium filling the joint space laterally (arrow). This mass has resulted in lateral femoral neck osseous erosion (curved arrow). (B) Oblique sagittal T1, fat-suppressed MR arthrogram image. In the joint space anterior to the femoral neck there is massive proliferation of the synovium (arrow), which obliterates the joint recess. This mass shows low signal intensity characteristic of hemosiderin-laden synovium of PVNS.

SUMMARY

Magnetic resonance imaging and magnetic resonance arthrography play increasingly important roles in the workup of the athlete who has hip pain. Occult osseous injury and the spectrum of musculotendinous injury are rapidly diagnosed with MRI, thereby guiding clinical and surgical management and helping determine when the athlete may safely return to competition. MR ar-thrography is the examination of choice for suspected labral and chondral injuries and optimizes depiction of synovial disease.

References

[1] Anderson K, Strickland SM, Warren R. Hip and groin injuries in athletes. Am J Sports Med 2001;29(4):521-33.

[2] Boutin RD, Newman JS. MR imaging of sports-related hip disorders. Magn Reson Imaging Clin N Am 2003;11:1-27.

[3] BencardinoJT, Palmer WE. Imaging of hip disorders in athletes. Radiol Clin N Am 2002;40: 267-87.

[4] Ganz R, ParviziJ, BeckM, etal. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop 2003;417:112-20.

[5] BeckM, KalhorM, Leunig M, etal. Hip morphology influences the pattern of damage to articular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br 2005;87-B:1012-8.

[6] Tanzer M. Noiseux. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop 2004;429:170-7.

[7] HickmanJM, PetersCL. Hip pain in the young adult: diagnosisand treatmentof disorders of the acetabular labrum and acetabular dysplasia. Am J Orthop 2001;30:459-67.

[8] Jacobsen S, Sonne-Holm S, Soballe K, et al. Hip dysplasia and osteoarthosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Acta Orthop 2005;76(2):149-58.

Newberg AH, Newman JS. Imaging the painful hip. Clin Orthop 2003;406:19-28.

Anderson MW, Greenspan A. Stress fractures. Radiology 1996;199:1-12.

Daffner RH, Pavlov H. Stress fractures: current concepts. AJR Am J Roentgenol 1992;159:

245-52.

Sterling JC, Edelstein DW, Calvo RD, etal. Stress fractures in the athlete: diagnosis and management. Sports Med 1992;14(5):336-46.

Spitz DJ, Newberg AH. Imaging of stress fractures in the athlete. Radiol Clin N Am 2002;40:313-31.

Egol KA, Koval KJ, Kummer F, et al. Stress fractures of the femoral neck. Clin Orthop 1998;348:72-8.

Slocum KA, Gorman JD, PuckettML, etal. Resolution of abnormal MR signal intensity in patients with stress fractures of the femoral neck. AJR Am J Roentgenol 1997;168:1295-9. Johansson C, Ekenman I, Tornkvist H, etal. Stress fractures of the femoral neck in athletes: the consequence of a delay in diagnosis. Am J Sports Med 1990;18(5):524-8. Myburgh KH, HutchinsJ, Fataar AB, et al. Low bone density is an etiologic factor for stress fractures in athletes. Ann Intern Med 1990;113(10):754-9.

Braam LA, Knapen MH, Geusens P, et al. Factors affecting bone loss in female endurance athletes: a two-year follow-up study. Am J Sports Med 2003;31(6):889-95. Bono CM. Low back pain in athletes. J Bone Joint Surg Am 2004;86-A(2):382-96. Major NM, Helms CA. Sacral stress fractures in long-distance runners. AJR Am J Roentgenol 2000;174:727-9.

Lee SW, Lee CH. Fatigue stress fractures of the pubic ramus in the Army: imaging features with radiographic, scintigraphic and MR imaging findings. Korean J Radiol 2005;6(1): 47-51.

Williams TR, PuckettML, Denison G, etal. Acetabular stress fractures in military endurance atheletes and recruits: incidence and MRI and scintigraphic findings. Skeletal Radiol 2002;31(5):277-81.

Palmer WE, Kuong SJ, Elmadbouh HM. MR imaging of musculoskeletal strain. AJR Am J Roentgenol 1999;173:703-9.

Boutin RD, Fritz RC, Steinbach LS. Imaging of sports-related muscle injuries. Radiol Clin N Am 2002;40:333-62.

DeSmet AA, Best TM. MR Imaging of the distribution and location of hamstring injuries in athletes. AJR Am J Roentgenol 2000;174:393-9.

Stevens MA, El-Khoury GY, Kathol MH, et al. Imaging features of avulsion injuries. Radiographics 1999;19:655-72.

Koulouris G, Connell D. Hamstring muscle complex: an imaging review. Radiographics 2005;25:571-86.

Steinbach LS, Schneider R, Goldman AB, etal. Bursae and abscess cavities communicating with the hip: diagnosis using arthrography and CT. Radiology 1985;156(2):303-7. Kozlov DB, Sonin AH. Iliopsoas bursitis: diagnosis by MRI. J Comput Assist Tomogr 1998;22(4):625-8.

Cvitanic O, Henzie G, Skezas N, et al. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus). AJR Am J Roentgenol 2004;182:137-43. Ito K, Leunig M, Ganz R. Histopathologic features of the acetabular labrum in femoroacetab-ular impingement. Clin Orthop 2004;429:262-71.

Beall DP, Sweet CF, Martin HD, et al. Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 2005;34:691-701.

Wenger DE, Kendell KR, Miner MR, etal. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop 2004;426:145-50.

Kassarjian A, Yoon LS, Belzile E, et al. Triad of MR arthographic findings in patients with cam-type femoroacetabular impingement. Radiology 2005;236:588-92. Petersilge CA, Haque MA, Petersilge WJ, et al. Acetabular labral tears: evaluation with MR arthrography. Radiology 1996;200:231-5.

[36] Czerny C, Hofmann S, Neuhold A, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology 1996;200:225-30.

[37] Czerny C, Hofmann S, Urban M, et al. MR arthrography of the adult capsular-labral complex: correlation with surgery and anatomy. AJR Am J Roentgenol 1999;173:345-9.

[38] McCarthy JC, Lee J-A. Arthroscopic intervention in early hip disease. Clin Orthop 2004;429:157-62.

[39] Mason JB. Acetabular labral tears in the athlete. Clin Sports Med 2001;20(4):779-90.

[40] Lequesne M. The false profile view of the hip: role, interest, economic considerations. Joint Bone Spine 2002;69(2):109-13.

[41] Leunig M, Podeszwa D, BackM, etal. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop 2004;418:74-80.

[42] Schnarkowski P, Steinbach LS, Tirman PFJ, etal. Magnetic resonance imaging of labral cysts of the hip. Skeletal Radiol 1996;25:733-7.

[43] Keeney JA, Peelle MW, Jackson J, et al. Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop 2004;429:163-9.

[44] Leunig M, BeckM, KalhorM, etal. Fibrocystic changes at the anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 2005;236:237-46.

[45] Weaver CJ, Major NM, Garrett WE, et al. Femoral head osteochondral lesions in painful hips in athletes: MR imaging findings. AJR Am J Roentgenol 2002;178:973-7.

[46] Moorman CT, Warren RF, Hershman EB, et al. Traumatic posterior hip subluxation in American football. J Bone Joint Surg Am 2003;85-A:1190-6.

[47] Beltran J, Herman LJ, BurkJM, etal. Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation. Radiology 1988;166:215-20.

[48] Maurice H, Crone M, Watt I. Synovial chondromatosis. J Bone Joint Surg Br 1988;70(5): 807-11.

[49] Robinson P, White LM, Kandel R, etal. Primary synovial osteochondromatosis of the hip. Extracapsular patterns of spread. Skeletal Radiol 2004;33(4):210-5.

[50] Cheng XG, You YH, Liu W, et al. MRI features of pigmented villonodular synovitis (PVNS). Clin Rheumatol 2004;23(1):31-4.

[51] HughesTH, Sartoris DJ, Schweitzer ME, etal. Pigmented villonodular synovitis. MRI characteristics. Skeletal Radiol 1995;24(1):7-12.

[52] Cotton A, Flipo RM, Chastanet P, etal. Pigmented villonodular synovitis of the hip: review of radiographic features in 58 patients. Skeletal Radiol 1995;24(1):1-6.

Clin Sports Med 25 (2006) 635-657

Was this article helpful?

0 0
Natural Arthritis Relief

Natural Arthritis Relief

Natural Arthritis Relief details a unique method of reversing Rheumatoid Arthritis Symptoms by removing numerous arthritis triggers as well as toxins using a simple 5 step natural process.

Get My Free Ebook


Post a comment