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Musculoskeletal Imaging |
1 From the Departments of Radiology (M.R.S., M.Z., J.H.) and Orthopedic Surgery (H.P.N., T.F.W.), Orthopedic University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland. From the 2001 RSNA scientific assembly. Received February 1, 2002; revision requested March 25; revision received April 15; accepted June 3. Address correspondence to M.R.S. (e-mail: mariusschmid@hotmail.com).
PURPOSE: To evaluate the diagnostic performance of magnetic resonance (MR) arthrography in the detection of articular cartilage lesions in patients suspected of having femoroacetabular impingement and/or labral abnormalities.
MATERIALS AND METHODS: Forty-two MR arthrograms obtained in 40 patients with a clinical diagnosis of femoroacetabular impingement and/or labral defect were retrospectively analyzed. Two readers independently interpreted the images for cartilage lesion location, depiction, and characteristics. Within 6 months after MR arthrography, each patient underwent open hip surgery, during which the entire cartilage of the hip joint was inspected. Sensitivity, specificity, accuracy, and positive and negative predictive values were calculated. 
values were calculated to quantify the level of interobserver agreement.
RESULTS: At surgery, most (37 [88%] of 42) cartilage defects were identified in the anterosuperior part of the acetabulum. In 23 (55%), 12 (29%), 10 (24%), and 10 (24%) hips, lesions were found in the posterosuperior acetabulum, anteroinferior acetabulum, posteroinferior acetabulum, and femoral head, respectively. The sensitivities and specificities of MR arthrographic detection of cartilage damage in all regions combined were 79% (73 of 92 regions) and 77% (91 of 118 regions), respectively, for reader 1 and 50% (46 of 92 regions) and 84% (99 of 118 regions), respectively, for reader 2. At interobserver comparison, agreement was fair ( = 0.31) for detection of cartilage lesions in the femoral head and poor ( 
0.2) for detection of lesions in all acetabular regions.
CONCLUSION: Cartilage lesions are common in young and middle-aged patients with femoroacetabular impingement and/or labral abnormalities and are most frequently found in the anterosuperior part of the acetabulum.
© RSNA, 2003
Index terms: Arthritis, degenerative, 442.772 • Cartilage, MR, 442.121411, 442.121412, 442.121415, 442.12143 • Hip, arthrography • Hip, MR, 442.121411, 442.121412, 442.121415, 442.12143 • Magnetic resonance (MR), arthrography, 442.121411, 442.121412, 442.121415, 442.12143
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