Hip MRI Fellowship Practice Cases

Hip & Thigh

Stephen J Pomeranz

Jenny T Bencardino

Edward Smitaman

Gain confidence reading and reporting on Hip MRI Cases with the Medality Fellowship Certificate Program. Practice using real-world, scrollable cases, earn CME, and receive a Fellowship Certificate™ upon completion!

Case Review

Musculoskeletal (MSK)

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Course Evaluation

Post-Course Activities

Welcome to the Hip MRI Fellowship Practice Cases course! In this course, you&rsquo;ll be presented with a series of worklists, comprised of 25 essential cases you must review to receive your Fellowship Certificate.

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Access Full Fellowship Certificate Program <a href="https://mrionline.com/proficiency/hip-mri-fellowship-certificate/" style="text-decoration:none">Here</a>&nbsp;

Hip MRI Practice Cases

Patient History: 26-yo female with left hip sprain. 

Findings
SKELETAL: Abnormal fat and water-weighted signal within the left femur from the proximal diaphysis through the intertrochanteric region into the femoral neck, with infiltration and mass-like soft tissue in the surrounding periosteum and musculature. Cortical breakthrough at the medial aspect of the proximal left femur just anterior to the lesser trochanter. No unstable fracture. Bone island in the right ischium.

PELVIS: No free fluid. No hernia. No lymphadenopathy.

JOINTS: Normal joint spaces.

ACETABULUM/LABRUM: Normal.

MUSCLES/TENDONS/LIGAMENTS: Intact tendons. No muscle tear.

OTHER/SOFT TISSUE: No lymphadenopathy.

Conclusion
Infiltrative destructive lesion within the left femur with infiltration of the surrounding soft tissues. Ill-defined zone of transition. Cortical breakthrough anteromedial to the proximal femur just anterior to the lesser trochanter. No pathologic or unstable fracture. Differential diagnostic considerations include Ewing’s tumor of adult, eosinophilic granuloma, chondromyxoid fibroma; osteoid producing lesion felt less likely given lack of low signal/bony matrix. Correlate with plain radiograph or CT to further evaluate matrix.


What is the best next step to best characterize this finding?