A study on plain radiograph and MR evaluation of painful HIP joint

Abstract

Background and Objectives:Hip joint pain is a common complaint in the present day practice and could be due to various reasons, as the investigations are invariably used to come to a diagnosis of the cause of pain. Plain radiographs are used as primary investigation followed by MRI which is a valuable tool in the evaluation of hip disorders. MR imaging is the modality of choice when clinical examination is suspect for hip disease and plain radiographs are normal or equivocal. Early diagnosis and treatment is important in many of the disorders.Materials and Methods:A prospective cross sectional study is done on a total of 50 patients including both the sexes and of  all age groups who presented with hip joint  pain and subsequently underwent plain radiographs followed by MRI of the hip joint. The data is analysed and the findings on plain radiographs correlated with that of MRI.Results: Of the 50 cases the males (70%) are commonly affected than females (30%). Majority of the patients fall under the age group of  31-40 years (28%).  In our study we find the commonest pathology for the hip joint pain is AVN of femoral head 16 cases (32%), followed by joint effusion 12 cases(24%), Osteoarthritis 10 cases(20%), TB hip 6 cases (12%), Perthes  2  cases  (4%), DDH 2 cases (4%) and metastatic disease 2cases (4%). Out of 16 cases of AVN only 4 (25%) cases are detected on plain radiograph where as all the 16 cases (100%) are diagnosed on MRI. Similarly out of 12 cases diagnosed as joint effusion only 4cases (33%) are detected on plain radiograph, but all the 12 cases (100%) are detected on MRI. Rest of the pathologies are detected 100% both on X-ray and MRI however, MRI helps in better delineation of articular cartilage, epiphyses and extra articular soft tissue abnormalities. Conclusion:The hip is a stable, major weight-bearing joint with significant mobility. Plain radiography is a widely established, economical investigation readily available in all kinds of health setups for imaging the hip  joint. Plain  film radiography is used in the initial evaluation of any cause of hip pain. MRI of the hips should be performed early in patients with persistent pain and negative radiography findings. MR imaging is a valuable tool in the evaluation of hip disorders because it enables assessment of articular cartilage, epiphyses, joint fluid, bone marrow and extra-articular soft tissues structures  that can be affected by hip disease.