Pelvis/Hip

Abstract

Patients with “hip pain” can have a variety of disorders that may or may not originate from the hip joint. Disorders of the lower lumbar spine, sacroiliac joints, and surrounding muscles can refer pain to the hip region. Therefore, it is good practice to have at least two MR protocols for evaluating the pelvis and hip. One protocol should have a large field of view (FOV) that includes the iliac crests through the lesser trochanters bilaterally. This large FOV protocol can detect fractures of the proximal femurs, sacrum, and pelvic bones, as well as identify sacroiliitis, lower lumbar spine degenerative changes, osteonecrosis, greater trochanter bursitis, and marrow-replacing lesions. A second protocol using a smaller FOV focused on the affected hip can assess patients with suspected intra-articular hip abnormalities, typically of the acetabular labrum and articular cartilage. For symptoms highly suspected to be due to labral pathology, MR arthrography is likely the best test to assess for labral tears.