Derek Armfield MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Professional sports, especially golf, subject the hip to extreme mechanical forces resulting in labral, capsular, and ligamentous injuries. We sought to 1) evaluate the role of MRI in golf-related hip labral injuries and 2) correlate MRI to arthroscopic findings in elite players. Methods and Materials: Eight elite golfers were studied. All patients underwent physical examination, MRI, and subsequent hip arthroscopy by one surgeon. Initial MRI readings and retrospective review readings were performed, both blinded to arthroscopy findings. Labra were graded for detachment (location, extent), tears (location, length), fraying, intra-labral signal, and cysts. Bone edema and articular cartilage injuries were also recorded. MRI findings were correlated arthroscopic findings. Results: At retrospective MRI review (blinded to arthroscopy results) all patients had labral pathology ranging from increased intra-labral signal to detachment and tears. They also had acetabular chondral changes (grade II-IV). At arthroscopy all patients had labral tears, acetabular cartilage-labral junction detachment, and grade III-IV chondral lesions. Abnormal labral and cartilage MRI exams were highly correlated to abnormal arthroscopy exams. Extent of tears as measured by MRI and arthroscopy were poorly correlated. Conclusion: Radiologists need to be aware of golf-related intraarticular hip pathology, especially labral tears, cartilage-labral junction detachment, and acetabular chondromalacia. The relationship between an abnormal MRI labral exam and an abnormal arthroscopic labral exam was good. Correlation on extent of tears was not as good. While these results are promising it is important to remember this is a limited study. We are continuing this study and have expanded it to include capsular and ligamentous involvement and postoperative outcome.      

Armfield MD, D, PGA Hip Tour: Labral Injuries.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3107344.html