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Cartilage Lesions in the Hip: Diagnostic Effectiveness of MR Arthrography¹

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).

View larger version (147K): [in a new window]   Figure 1a. MR images of acetabular cartilage defect adjacent to complete labral tear in a 32-year-old man. (a) Coronal T1-weighted (800/12), (b) coronal T1-weighted fat-saturated (806/20), and (c) sagittal T1-weighted (600/12) images clearly show the complete labral tear (large arrow in a and b) in the anterosuperior part of the labrum and the adjacent loss of articular cartilage (arrowheads) in the anterior part of the left superior acetabulum. Intact femoral cartilage (small arrows in a and b) in the corresponding area also is seen. The contrast material within the joint space is visible only in the area of cartilage loss.

View larger version (120K): [in a new window]   Figure 1b. MR images of acetabular cartilage defect adjacent to complete labral tear in a 32-year-old man. (a) Coronal T1-weighted (800/12), (b) coronal T1-weighted fat-saturated (806/20), and (c) sagittal T1-weighted (600/12) images clearly show the complete labral tear (large arrow in a and b) in the anterosuperior part of the labrum and the adjacent loss of articular cartilage (arrowheads) in the anterior part of the left superior acetabulum. Intact femoral cartilage (small arrows in a and b) in the corresponding area also is seen. The contrast material within the joint space is visible only in the area of cartilage loss.

View larger version (129K): [in a new window]   Figure 1c. MR images of acetabular cartilage defect adjacent to complete labral tear in a 32-year-old man. (a) Coronal T1-weighted (800/12), (b) coronal T1-weighted fat-saturated (806/20), and (c) sagittal T1-weighted (600/12) images clearly show the complete labral tear (large arrow in a and b) in the anterosuperior part of the labrum and the adjacent loss of articular cartilage (arrowheads) in the anterior part of the left superior acetabulum. Intact femoral cartilage (small arrows in a and b) in the corresponding area also is seen. The contrast material within the joint space is visible only in the area of cartilage loss.

View larger version (128K): [in a new window]   Figure 2. Coronal T1-weighted MR image (800/12) obtained in the contralateral hip of the patient in Figure 1 shows an incomplete tear (white arrow) in the anterosuperior part of the labrum and adjacent loss of articular cartilage (arrowhead) in the right acetabulum. Although surgery revealed no cartilage defects in the femoral head, osteophytes (black arrow) can be seen at the superior border of the femoral head-neck junction.

View larger version (131K): [in a new window]   Figure 3. Oblique-transverse FLASH MR image (400/11, 60° flip angle) shows a small contrast material-filled femoral cartilage defect (arrowheads) in a 42-year-old woman with early osteoarthritis of the right hip joint. Adjacent cartilage (white arrow) has a hypointense signal. Partial detachment of the anteroinferior acetabular labrum (black arrow) without an adjacent cartilage defect also is seen.

View larger version (140K): [in a new window]   Figure 4a. (a, b) Consecutive oblique-transverse FLASH MR images (400/11, 60° flip angle) show signal intensity alterations within the anterior part of the femoral head cartilage (arrows) in a 48-year-old woman. There was no evidence of a defect at surgery. The small amount of contrast material visible in the joint space is caused by a depression of the hyaline cartilage layer and the underlying subchondral bone (arrowheads) and is not related to thinning or defect of the cartilage layer.

View larger version (129K): [in a new window]   Figure 4b. (a, b) Consecutive oblique-transverse FLASH MR images (400/11, 60° flip angle) show signal intensity alterations within the anterior part of the femoral head cartilage (arrows) in a 48-year-old woman. There was no evidence of a defect at surgery. The small amount of contrast material visible in the joint space is caused by a depression of the hyaline cartilage layer and the underlying subchondral bone (arrowheads) and is not related to thinning or defect of the cartilage layer.