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Femoral Head Osteochondral Lesions in Painful Hips of Athletes

MR Imaging Findings

Carolyn J. Weaver1, Nancy M. Major, William E. Garrett and James E. Urbaniak

1 All authors: Department of Radiology, Duke University Medical Center, P. O. Box 3808, Durham, NC 27710.



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  		Fig. 1A. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Coronal T1-weighted image (TR/TE, 600/13) shows triangular-shaped area of decreased signal in 10-11 o'clock position (arrow).

 


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  		Fig. 1B. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Coronal T2-weighted image with fat suppression (TR/TEeff, 3500/65) shows corresponding area of increased signal (arrow). Overlying cartilage is not seen well on this image.

 


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  		Fig. 1C. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Axial T1-weighted image (TR/TE, 600/13) shows medial location of this injury, as evidenced by decreased signal in marrow (arrow).

 


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  		Fig. 1D. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Coronal T1-weighted image (600/13) obtained at follow-up shows irregular contour in medial aspect of femoral head in location of previously seen triangular-shaped signal abnormality (arrow).

 


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  		Fig. 1E. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Corresponding coronal T2-weighted fat-suppressed image (TR/TEeff, 3500/65) shows increased signal adjacent to region of curvilinear decreased signal in subarticular medial aspect of femoral head (arrow). Overlying cartilage may be thin in this location. Amount of edema has decreased in comparison with prior examination (B), but lesion is more organized.

 


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  		Fig. 1F. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Axial T1-weighted image (TR/TE, 600/13) shows decrease in bone marrow edema in comparison with prior study (C) (arrow).

 


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  		Fig. 1G. —26-year-old male soccer player at time of presentation with 6-month history of left hip pain (A—C) and at 2-month follow-up (D—G). Axial T2-weighted image with fat suppression (TR/TEeff, 3500/65) shows decreased edema with focal area of high signal (arrow).

 


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  		Fig. 2A. —28-year-old male skier with 3-month history of hip pain. Coronal T1-weighted image (TR/TE, 600/13) shows decreased signal in subchondral bone at medial aspect of femoral head (arrow).

 


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  		Fig. 2B. —28-year-old male skier with 3-month history of hip pain. Corresponding coronal (fast) short tau inversion recovery image (4000/35; inversion time, 150 msec) reveals increased signal in subchondral bone (thick arrow), with visible cartilage loss shown by joint fluid filling location of cartilage defect (thin arrow).

 


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  		Fig. 3A. —21-year-old male soccer player with acute hip pain. Coronal T2-weighted fat-suppressed image (TR/TEeff, 3500/65) shows area of increased signal consistent with bone marrow edema in medial aspect of femoral head (arrow).

 


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  		Fig. 3B. —21-year-old male soccer player with acute hip pain. Corresponding axial T2-weighted fat-suppressed image (3500/65) shows irregularity along articular surface compatible with small osteochondral lesion (arrow). Bone marrow edema is evident.

 


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  		Fig. 4. —25-year-old male soccer player with 1-month history of hip pain. Image taken at time of arthroscopy shows large, irregular defect in femoral head articular cartilage (arrows). This defect is located over anteromedial aspect of femoral head.

 

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