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Wk 7, Case 5, Hip MR - Review

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Report

Patient History

Patient states pain in posterior hip joint for 1 day. Patient's pain started after being tackled last night in a football game.

Findings

SKELETAL: Mildly displaced osseous fragment measuring 1.1cm x 1.2cm x 3cm (AP, transverse and CC dimensions) involving the entire posterior acetabular column.

PELVIS: Visualized right sacroiliac joint, right iliac blade, iliopectineal and ilioischial lines are intact.

JOINTS: No hip osteoarthrosis or chondromalacia.

Small effusion or hemarthrosis. No internal debris or free bodies.

Supra-acetabular fossa as anatomic variant and incidental finding.

Ligamentum teres is mildly sprained. The iliofemoral and ischiofemoral ligaments are intact.

Normal femoral head sphericity. No acetabular under or over coverage. Normal tapering at the femoral head-neck junction.

ACETABULUM/LABRUM: Nondisplaced posterosuperior to posteroinferior labral tear. No paralabral cyst.

MUSCLES/TENDONS/LIGAMENTS: Moderate-grade strain of the piriformis, gemelli, obturators internus muscle and tendons.

The rest of the adductor and abductor muscles are intact.

OTHER/SOFT TISSUE: Mild diffuse periarticular soft tissue swelling.

Unremarkable pelvic basin contents. Normal neurovascular bundle.

Impressions

1. Sequela of recent right hip dislocation/relocation suggested by the presence of a mildly displaced 3cm osseous fragment of the posterior acetabular column.

2. Nondisplaced posterosuperior to posteroinferior labral tear. No paralabral cysts.

3. Moderate grade strain of the piriformis, gemelli, obturators internus muscle and tendons.

4. Small effusion or hemarthrosis.

Case Discussion

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Gitanjali Bajaj, MD

Assistant Professor

University of Arkansas for Medical Sciences

Edward Smitaman, MD

Clinical Associate Professor

University of California San Diego

Brian Y. Chan, MD

Assistant Professor of Musculoskeletal Radiology

University of Utah

Tags

Musculoskeletal (MSK)

MRI

Hip & Thigh

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