11/7/2023 0 Comments Superior acetabularThe bore of the magnet is now shorter, allowing for better patient acceptance. The new high-field-strength magnets operating at 1.5 Tesla are more comfortable for the patient. MRI can be performed rapidly, is cost effective, and is sensitive and specific for the diagnosis of occult fracture. In the athlete with a suspected stress fracture, it is best to choose MRI as the first advanced imaging test. Often the initial radiographs are normal, especially in the elderly os-teoporotic patient. The diagnosis of an occult hip fracture can be elusive. In this chapter the authors will describe the imaging characteristics of several common atraumatic and traumatic lesions, as well as discuss the more advanced techniques of MRI and MR arthrography when assessing for more localized hip joint abnormalities. If the trauma is repetitive and a stress or fatigue fracture is being considered, radiographs must be supplemented with either a radionuclide bone scan and/or MRI. The CT is often vital for operative planning. If an acetabular fracture is identified, a CT scan is suggested to assess the position of the fracture fragments and to exclude intra-articular loose bodies. The addition of oblique views of the affected hip may be necessary to evaluate the anterior and posterior columns of the acetabulum. The acetabular lines should be carefully scrutinized. The diagnosis in many cases is obvious if the patient has had recent trauma, then one evaluates the alignment of the bones. Certainly, by obtaining an anteroposterior view of the pelvis, as well as a lateral radiograph (true lateral, frog lateral, or Lowenstein view) one can readily compare the right and left hips, and therefore a built-in comparison is available for the radiologist and orthopedist. The imaging workup of the patient with hip pain should begin with plain or routine radiographs of the pelvis and hips.
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