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Triad of MR Arthrographic Findings in Patients with Cam-Type Femoroacetabular Impingement¹

¹ From the Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, 55 Fruit St, Yawkey Center, 6th Floor, Boston, MA 02114 (A.K., L.S.Y., W.E.P.); Department of Orthopedic Surgery, Centre Hospitalier Universitaire de Quebec, Quebec, Canada (E.B.); and Departments of Radiology (S.A.C.) and Orthopedic Surgery (M.B.M.), Boston Children's Hospital, Boston, Mass. From the 2004 RSNA Annual Meeting. Received November 23, 2004; revision requested January 18, 2005; revision received January 20; accepted February 16. Address correspondence to A.K. (e-mail: akassarjian{at}partners.org).

PURPOSE: To retrospectively analyze magnetic resonance (MR) arthrographic findings in patients with clinical cam-type femoroacetabular impingement.

MATERIALS AND METHODS: This study was approved by the institutional review board, and informed consent was waived. Study was compliant with the Health Insurance Portability and Accountability Act. Forty-two MR arthrograms obtained in 40 patients with clinical femoroacetabular impingement were analyzed retrospectively by two radiologists. Quantitative analysis by using angle measurement was performed to assess anterosuperior femoral head-neck morphology. Presence of labral tears, articular cartilage lesions, paralabral cysts, os acetabuli, and synovial herniation pits was recorded. Presence of the typical triad of anterosuperior labral tear, anterosuperior cartilage lesion, and abnormal angle was recorded. Surgical comparison was available for 11 patients.

RESULTS: At imaging, in 40 patients (22 male, 18 female) with a mean age of 36.5 years, 39 of 42 hips (93%) had an abnormal angle, with a mean angle of 69.7°; 40 of 42 (95%) had an anterosuperior cartilage abnormality; and 42 of 42 (100%) had an anterosuperior labral tear. Thirty-seven of 42 hips (88%) had the triad. Six had paralabral cysts, 17 had an os acetabuli, and two had synovial herniation pits. Surgical comparison for 11 hips led to confirmation of all labral and cartilage abnormalities seen at imaging.

CONCLUSION: MR arthrography demonstrated a triad of abnormal head-neck morphology, anterosuperior cartilage abnormality, and anterosuperior labral abnormality in 37 of 42 patients with cam-type femoroacetabular impingement.

© RSNA, 2005

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