Tubular Acetabular Intraosseous Contrast Tracking in MR Arthrography of the Hip: Prevalence, Clinical Significance, and Mechanisms of Development
Li-Chang Lien1,
John C. Hunter2 and
Yi-Sheng Chan3
1 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital,
College of Medicine, Chang Gung University, 5 Fu-Hsing St., Gui-Shan, Tao-Yuan
33300, Taiwan.
2 Department of Radiology, Musculoskeletal Section, University of California
Davis School of Medicine, Sacramento, CA.
3 Department of Orthopedics, Chang Gung Memorial Hospital, College of Medicine,
Chang Gung University, Taiwan.
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Fig. 1A —54-year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images show asymptomatic hip in craniocaudal sequence. Normal posterior margin
(arrowhead) of acetabular fossa.
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Fig. 1B —54-year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images show asymptomatic hip in craniocaudal sequence. Tubular intraosseous
contrast tracking (arrow) arising from junction of articular
cartilage and posterior margin of acetabular fossa.
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Fig. 1C —54-year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images show asymptomatic hip in craniocaudal sequence. Blind end of
intraosseous contrast tracking shows mild dilatation known as clubbing
phenomenon (asterisk).
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Fig. 2A —43-year-old woman with suspected acetabular labral tears.
Axial fat-suppressed 3D fast low-angle shot (TR/TE, 48/11; flip angle,
40°) MR arthrographic image of hip shows posterior acetabular intraosseous
contrast tracking (arrow) at level of mid acetabular fossa.
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Fig. 2B —43-year-old woman with suspected acetabular labral tears.
Arthrographic CT scan of hip shows posterior acetabular intraosseous contrast
tracking (arrow) at level of mid acetabular fossa. Small gap exists
between track orifice (white arrowhead) and junction (black
arrowhead) of articular cartilage and acetabular fossa.
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Fig. 3A —52 year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images in cranial-caudal sequence show asymptomatic hip. Anterior tubular
track (A) originates from margin (arrow) of acetabular fossa close to
articular cartilage (arrowhead).
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Fig. 3B —52 year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images in cranial-caudal sequence show asymptomatic hip. Anterior tubular
track (A) originates from margin of acetabular fossa. Posterior tubular track
(P) originates from junction (arrow) of posterior margin of
acetabular fossa and articular cartilage.
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Fig. 3C —52 year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images in cranial-caudal sequence show asymptomatic hip. Posterior tubular
track (P) originates from junction of posterior margin of acetabular fossa and
articular cartilage.
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Fig. 3D —52 year-old woman who underwent bilateral hip imaging for
suspected unilateral acetabular labral tears. Consecutive axial fat-suppressed
3D fast low-angle shot (TR/TE, 48/11; flip angle, 40°) MR arthrographic
images in cranial-caudal sequence show asymptomatic hip. Dilatation of blind
end of posterior tubular track known as clubbing phenomenon
(asterisk) is evident.
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Fig. 4A —50-year-old man with suspected acetabular labral tears.
Coronal (A) and sagittal (B) fat-suppressed T1-weighted MR
arthrographic images (TR/TE, 500/11) show ovoid subchondral cyst
(arrows) in weight-bearing region of bony acetabulum. Intermediate
signal intensity of cyst content without contrast fill-in is evident. No
definite acetabular labral tears are present.
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Fig. 4B —50-year-old man with suspected acetabular labral tears.
Coronal (A) and sagittal (B) fat-suppressed T1-weighted MR
arthrographic images (TR/TE, 500/11) show ovoid subchondral cyst
(arrows) in weight-bearing region of bony acetabulum. Intermediate
signal intensity of cyst content without contrast fill-in is evident. No
definite acetabular labral tears are present.
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Fig. 5 —Drawing shows typical locations of tubular acetabular
intraosseous contrast tracking over posterior-anterior margin
(arrowheads) of acetabular fossa, subchondral cyst over
weight-bearing surface of acetabular roof (star) and ischiopubic
flange of triradiate cartilage over center of acetabular fossa, and junction
(arrows) of pubis and ischium. IL = ilium. PU = pubis, IS =
ischium.
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Copyright © 2006 by the American Roentgen Ray Society.
