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Extra-articular Conditions

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Hip Magnetic Resonance Imaging

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Abstract

Lateral hip pain causes differential diagnostic problems because pain can arise from the hip joint itself or the periarticular soft tissues. Greater trochanteric pain is commonly caused by bursitis, tendinopathy, or tears of the gluteal tendons. Different conditions will be discussed such as abductor tendon pathologies, bursitis or tendinitis of the iliopsoas tendon. Additionally posttraumatic lesions and tumors will also be mentioned in this chapter.

Besides the evaluation of intraarticular hip pathologies, MRI enables the assessment of extraarticular soft tissues as well as the adjacent osseous structures that also can be affected by hip disease.

The imaging protocols are similar to the MR-arthrography protocols. In our institution two different imaging protocols besides the “MR-arthrography protocol” are used.

We apply a “standard hip protocol,” especially in older patients when no intraarticular contrast media is used or necessary: Intermediate weighted fast spin-echo images in coronal plane [TR/TE, 3,540 ms/39 ms], field of view (FOV) 160 × 100 mm, NEX 1, matrix 256 × 256, echo train length (ETL) 7, section thickness 3 mm; a T1-weighted fast-spin-echo sequence in coronal plane [TR/TE, 605 ms/12 ms], FOV 160 × 100 mm, NEX 2, matrix 512 × 256, ETL 7, section thickness 3 mm; a T1-weighted fast-spin-echo sequence in sagittal plane [TR/TE, 550 ms/13 ms], FOV 160 × 100 mm, NEX 3, matrix 512 × 256, ETL 3, section thickness 4 mm; a T2-weighted 3D fast imaging with steady-state free precession (true FISP) sequence in transverse plane [TR/TE, 11.69 ms/5.23 ms], FOV 170 × 100 mm, NEX 1, matrix 384 × 384, section thickness 1.25 mm; and a T2-weighted 3D double-echo steady state (DESS) in sagittal plane [TR/TE, 25.16 ms/8.56 ms], FOV 150 × 100 mm, NEX 2, matrix 256 × 192, section thickness 1.7 mm.

Questioning abnormalities of the abductor tendons we use a special “abductor tendon protocol”: Intermediate-weighted fast spin-echo images in coronal plane [repetition time/echo time (TR/TE), 2,590 ms/15 ms], FOV 180 × 143 mm, NEX 1, matrix 512 × 256, ETL 7, section thickness 3 mm; a T1-weighted spin-echo sequence in transverse plane [TR/TE, 533 ms/12 ms], FOV 180 × 180 mm, NEX 1, matrix 512 × 256, section thickness 6 mm, as well as a sagittal T1-weighted sequence [TR/TE, 400 ms/12 ms], FOV 180 × 180 mm, NEX 1, matrix 384 × 269, section thickness 4 mm and a transverse short inversion time inversion-recovery sequence (STIR) [TR/TE/TI, 4,890 ms/45 ms/150 ms], FOV 180 × 180 mm, NEX 1, matrix 256 × 179, ETL 9, section thickness 7 mm.

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Authors and Affiliations

  1. Department of Radiology, Center for Musculoskeletal Radiology, Hirslanden Clinic, Witelliker Street 40, Zurich, 8032, Switzerland

    Nadja Mamisch-Saupe MD

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  1. Nadja Mamisch-Saupe MD
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Correspondence to Nadja Mamisch-Saupe MD .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA

    Young-Jo Kim

  2. Department of Radiology, Brigham & Women's Hospital, Boston, Massachusetts, USA

    Tallal Charles Mamisch

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Mamisch-Saupe, N. (2014). Extra-articular Conditions. In: Kim, YJ., Mamisch, T. (eds) Hip Magnetic Resonance Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1668-5_13

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  • DOI: https://doi.org/10.1007/978-1-4614-1668-5_13

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  • Print ISBN: 978-1-4614-1667-8

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