Niamh M Long MD, Presenter: Nothing to Disclose

Neil Pravin Shah MD, Abstract Co-Author: Nothing to Disclose

Catherine Niyada Petchprapa MD, Abstract Co-Author: Nothing to Disclose

Roy Davidovitch, Abstract Co-Author: Nothing to Disclose

Jose Maria Raya Garcia Del Olmo PhD, Abstract Co-Author: Nothing to Disclose

Adler S. Ronald MD, PhD, Abstract Co-Author: Nothing to Disclose

Demonstrate the ability of real-time ultrasound to track the relationships between the acetabulum and femoral head (FH)/neck junction and evaluate labral morphology and femoral-labral relationship (FLR) during dynamic hip flexion (HF) and adduction/internal rotation (ADIR).

Ultrasound (US) and magnetic resonance (MR) evaluation of 10 hips in 5 asymptomatic subjects (4 Females, 1 Male, mean age/range 30.1/22-39 years). US (ACUSON S2000™, Siemens Healthcare, Mountainview, CA):High resolution longitudinal images of the femoral neck recorded at the level of the iliopsoas (IPT) and rectus femoris (RFT) tendons, and of the intervening anterosuperior (AS) labrum between them were acquired using 9 MHz linear phased array US transducer (TD).Dynamic US images, stored as cine clips, acquired in same orientation using 8 Mhz small footprint sector US TD positioned between IPT and RFT during continuous passive HF to 45/90 deg (10 subjects), and 45/90 degrees HF plus 60 degrees ADIR (6 subjects). All sonographic imaging performed by one radiologist with expertise in MSK US. MR: Coronal, axial oblique fat suppressed proton density images of each hip (SKYRA; Siemens, Mountainview, CA, phased array coil, TR/TE 2800/37).Consensus review of static US for appearance of AS labrum and chondrolabral junction (CLJ), and dynamic US for FLR, course of FH motion, presence of bony conflict. MR images evaluated for presence/absence of labral/CLJ pathology,cam lesion.

STATIC STUDY: MR:(1/10) cam, (5/10) labral tears, (9/10) CLJ separations. US:(8/10) labral tears, (5/10) CLJ separations. DYNAMIC STUDY: Labrum visualized to 45 deg HF (10/10), 90 deg HF (0/10), and 45 deg HF/30 deg ADIR (5/6). Labrum remained apposed to FH surface up to 45 deg HF (10/10) and vertically displaced between 45-90 HF (3/10), FH rotated smoothly under acetabular rim (10/10);(0/10) bony conflict during F/ADIR.  

Dynamic US can evaluate labrum and femoroacetabular relationships during dynamic 45 deg HF and 30 deg ADIR. FH rotates smoothly under acetabular rim without bone/soft tissue conflict, and labrum rides along the surface of the femoral head as the hip is flexed.

Dynamic US combined with clinical hip examination for femoroacetabular impingement (FAI) can be used to evaluate subjects with FAI and pain. 

Long, N, Shah, N, Petchprapa, C, Davidovitch, R, Raya Garcia Del Olmo, J, Ronald, A, Dynamic Sonography of the Anterosuperior Hip during Flexion, Adduction/Internal Rotation: A Pilot Study.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044189.html