The Role of Multidetector CT Arthrography in the Investigation of Suspected Intra-articular Hip Pathology
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The aim of this study was to evaluate the role of multidetector CT (MDCT) arthrography in the diagnosis of intra-articular hip pathology. A retrospective review of 96 patients who had undergone CT hip arthrography was performed. Data regarding the presence of a labral tear, paralabral cyst, chondral loss, acetabular version, femoral morphology and fibrocystic change were collected. We detected 28 labral tears (24 anterior, 2 anterolateral, 1 lateral and 1 posterolateral). An abnormal labral-chondral transitional zone was seen in 9 patients and 4 patients had surface labral fraying. We identified three paralabral cysts. Acetabular cartilage loss was detected in 45 and femoral cartilage loss in 9 patients. An abnormal anterior femoral head and neck junction was present in 18 hips and fibrocystic change in 8. Acetabular retroversion was present in 11 hips. 63 sets of patient notes were reviewed, of which 49 were in-patients with abnormal MDCT arthrogram findings. Surgical correlation was available in 27 patients. There was a discrepancy between the findings of a labral tear in one patient (false negative, 90% sensitivity and 100% specificity) and the presence of acetabular cartilage loss (88% sensitivity and 100% specificity) and femoral cartilage loss (94% sensitivity and 100% specificity) in three patients. MDCT arthrography affords accurate detection of intra-articular hip pathology.
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