Erb R E
Baptist Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Clin Sports Med. 2001 Oct;20(4):661-96. doi: 10.1016/s0278-5919(05)70278-7.
Diagnostic imaging plays a key role in the evaluation of adult hip pain. Cornerstone to the initial assessment of hip pain is the plain radiograph. The need for secondary imaging of the hip and choice of imaging modality depends on the clinical presentation, results of the plain radiograph series, and clinical question to be answered. CT is primarily used in acute trauma, particularly in cases of an acetabular fracture or hip dislocation to detect intraarticular fragments and associated articular surface fractures and to better depict fracture patterns for surgical planning. In the setting of normal plain radiographs and unexplained hip pain, MR imaging is particularly helpful in detecting marrow-based abnormalities and demonstrating intra- and extraarticular pathology. MR athrography is useful in the detection of labral injuries and potentially may demonstrate additional intraarticular pathology, including chondral damage, loose bodies, and injuries of the ligamentum teres.
诊断成像在成人髋关节疼痛的评估中起着关键作用。髋关节疼痛初步评估的基石是X线平片。髋关节二次成像的必要性及成像方式的选择取决于临床表现、X线平片系列检查结果以及有待解答的临床问题。CT主要用于急性创伤,尤其是髋臼骨折或髋关节脱位的病例,以检测关节内碎片及相关关节面骨折,并更好地描绘骨折类型,为手术规划提供依据。在X线平片正常但髋关节疼痛原因不明的情况下,磁共振成像(MR成像)对于检测骨髓异常以及显示关节内和关节外病变特别有帮助。磁共振关节造影有助于检测盂唇损伤,并且可能显示其他关节内病变,包括软骨损伤、游离体和圆韧带损伤。