APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-Imaging Studies: Plain Radiographs, MRI, CT

Video Transcription

Video Summary

This presentation emphasizes the critical role of accurate diagnosis and patient selection for hip arthroscopy, particularly in femoral acetabular impingement (FAI) syndrome. FAI involves abnormal contact between the femur and acetabulum, leading to cartilage damage and labral tears, typically detected through symptoms, signs, and imaging. The talk highlights the importance of thorough history, physical examination, and layered imaging—starting with AP pelvis and lateral X-rays, progressing to MRI/MRA and CT scans—to evaluate joint space, bony morphology, and soft tissue integrity. Special attention is given to differentiating CAM and pincer lesions and identifying contraindications like dysplasia or advanced arthritis. Ultrasound-guided intraarticular hip injections are recommended as a cost-effective, diagnostic adjunct distinguishing intra-articular from extra-articular pain. Serial radiographs are particularly useful in older patients to detect early degenerative changes. Successful outcomes depend on operating before advanced osteoarthritis develops, with a minimum of 3 mm joint space preferred. Proper imaging and diagnostics enable tailored, evidence-based intervention for hip preservation.

Asset Caption

Sanjeev Bhatia, M.D.

Keywords

hip arthroscopy

femoral acetabular impingement

diagnostic imaging

CAM and pincer lesions

intraarticular hip injections