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Direct MR Arthrography of the Hip with Leg Traction: Feasibility for Assessing Articular Cartilage

¹ Department of Radiology, Hospital de la Ribera, Carretera de Corbera km1, Alzira, Valencia, 46600, Spain.
² Instituto Radiologico Cantabro, Clinica Mompia, Santander, Spain.
³ Department of Radiology, Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA.
⁴ Department of Orthopedics, Hospital de la Ribera, Valencia, Spain.

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Traction device. Photographs show lateral adhesive straps (1) fixed parallel to thigh, leaving 5-cm distance between sole and plate (2), and fixed with bandage (3). System is loaded (B) to 6 kg (4).

View larger version (119K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Traction device. Photographs show lateral adhesive straps (1) fixed parallel to thigh, leaving 5-cm distance between sole and plate (2), and fixed with bandage (3). System is loaded (B) to 6 kg (4).

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —23-year-old male tennis player. MR arthrograms with and without traction show how well cartilage surfaces are depicted with traction. Coronal proton density–weighted fast spin-echo MR arthrogram without traction (A) and oblique sagittal fat-suppressed T1-weighted fast spin-echo image (B) readily show labral degeneration and tear, but femoral and acetabular cartilages are not evident as separate structures.

View larger version (74K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —23-year-old male tennis player. MR arthrograms with and without traction show how well cartilage surfaces are depicted with traction. Coronal proton density–weighted fast spin-echo MR arthrogram without traction (A) and oblique sagittal fat-suppressed T1-weighted fast spin-echo image (B) readily show labral degeneration and tear, but femoral and acetabular cartilages are not evident as separate structures.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —23-year-old male tennis player. MR arthrograms with and without traction show how well cartilage surfaces are depicted with traction. Traction proton density–weighted fast spin-echo (C) and fat-suppressed T1-weighted (D) images corresponding to A and B show separation (arrow) between cartilage surfaces, which allows assessment of cartilage defects. Labrum tear (arrowheads, C) is evident.

View larger version (83K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —23-year-old male tennis player. MR arthrograms with and without traction show how well cartilage surfaces are depicted with traction. Traction proton density–weighted fast spin-echo (C) and fat-suppressed T1-weighted (D) images corresponding to A and B show separation (arrow) between cartilage surfaces, which allows assessment of cartilage defects. Labrum tear (arrowheads, C) is evident.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —16-year-old female runner with unilateral left hip pain. Oblique sagittal T1-weighted MR images without (A) and with (B) traction show marked distention of deep central compartment hip that allows differentiation of articular femoral and acetabular cartilages as separate structures.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —16-year-old female runner with unilateral left hip pain. Oblique sagittal T1-weighted MR images without (A) and with (B) traction show marked distention of deep central compartment hip that allows differentiation of articular femoral and acetabular cartilages as separate structures.

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —28-year-old man with right hip pain. Oblique sagittal T1-weighted image MR arthrogram shows large subchondral lesion without involvement of articular cartilage (arrow).

View larger version (93K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5 —40-year-old man with decreased internal rotation of left hip. Oblique sagittal T1-weighted MR arthrogram shows large osteochondral anterosuperior lesion extending to cartilage and small cartilage flap (arrow).

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —37-year-old woman with right hip pain. Coronal proton density–weighted fast spin-echo images without (A) and with (B) traction. Cartilage defect (arrow, B) is evident only after application of traction.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —37-year-old woman with right hip pain. Coronal proton density–weighted fast spin-echo images without (A) and with (B) traction. Cartilage defect (arrow, B) is evident only after application of traction.

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