ORTHOPEDICS COMMUNITY
MRI Results... can someone please provide me a secondary opinion?

MRI Results... can someone please provide me a secondary opinion?

Procedure- MRI Right HIP Without contrast

Indications- Right hip pain, rule out labral tear versus loose body, 24 year old male

Impressions-
1) Positive for subchondral edema in the anterior acetabular rim as well as laterally with degenerative change in the anterolateral labrum and early osteophytic spurring at the lateral margin of the acetabulum.
2) Alpha angle measures 55 degrees (upper normal) buy subjectively the femoral head/neck junction does show relative lack of concavity and while a distinct femoral bump is not observed and there is no distinct anterior erosion the morphology of the femoral head and neck does suggest some predisposition to femoracetabular impingement anterolaterally.
3) While there is some increased signal intensity in the anterior labrum a distinct labral tear is not identified.
Technique- The patient is studied on the Siemens Symphony 1.5 Tesla high field short bore scanner.  Scan sequences include corona T1 and T2 weighted scans of the whole pelvis.  Localized T1 and fat suppressed T2 weighted scans in the coronal and axial plane are also obtained.

Discussion- Coronal images that include both hips demonstrate a slightly greater amount of joint fluid on the right than on the left but a larger pathological joint effusion is not present.  However, the right hip demonstrated thickening of the joint capsule laterally with altered bone marrow signal intensity in the subchondral bone of the anterior acetabulum over a wide area and there is some early osteophytic spurring at the lateral margin of the acetabulum.  The femoral head has a slightly convex anterolateral margin at the junction with the neck which could predispose to femoroacetabular impingement.  The anterior labrum here shows increased signal intensity on T1 weighted images suggesting intrasubstance degeneration but a distinct labral fissure is not definitely identified.  However, the bone marrow changes extended all the way down to the anterior sublabral region as well as laterally and could be in part the result of anterior impingement.  The articular cartilage over the femoral head appears fairly well preserved.  The acetabular articular cartilage is not well depicted.

The adjacent musculature is normal and the pelvic contents nearby are normal.  The pubic rami are intact and the femoral neck and trochanteric regions are normal with a bone island in the lateral proximal femoral diaphysis at the level of the lesser trochanter.

The alpha angle here is measured at 55 degrees, which is the upper limit of normal subjectively.   However, there appears to be relative lack of concavity in the femoral head cut back zone at the junction of the femoral head and neck.

Related Discussions
Post a Comment
To
Comment
Post A Comment
Go
Blank
Weight Tracker
Reach your weight goal faster
Start Tracking Now
MedHelp Health Answers
Submit
Top Orthopedics Answerers
Avatar_f_tn
Blank
PedroH
SK
RSS Expert Activity
2126606_tn?1335910182
Blank
Heroin Abuse on the Rise among U.S....
13 hrs ago by Clare Waismann Kavin, RASBlank
1741471_tn?1336957856
Blank
LIVE WEBINAR TOMORROW!-SUPER BODY, ... Blank
May 22 by Michael Gonzalez-WallaceBlank
2126606_tn?1335910182
Blank
Fibromyalgia Awareness
May 11 by Clare Waismann Kavin, RASBlank