McCall David A, Safran Marc R
Resident Physician, Stanford University Hospital and Clinics, Stanford University, Stanford, CA, USA.
Instr Course Lect. 2012;61:327-44.
Disorders of the hip joint can be physically disabling for the patient and a diagnostic challenge for the physician. Advances in imaging the hip with MRI can help the physician determine a more specific diagnosis for patients with acute or chronic hip pain. MRI and particularly magnetic resonance arthrography have helped raised awareness of nonarthritic hip problems and have made the diagnosis of hip problems much easier. Intra-articular and extra-articular processes can be evaluated with MRI; multiple sequences are available to increase the sensitivity and specificity for detecting specific pathology around the hip. Because the hip is a deep joint within a large soft-tissue envelope, MRI more precisely delineates the sources of hip pain by evaluating the soft tissues and ligamentous structures around the hip. It is helpful to understand the role of MRI in evaluating common pathologic conditions within the hip joint, including labral tears, chondral lesions, loose bodies, tears of the ligamentum teres, femoral acetabular impingement, developmental dysplasia of the hip, and pigmented villonodular synovitis. Hip arthroscopy, a less invasive technique for treating hip problems, has also contributed to the rapid growth of interest in this area of orthopaedic surgery. Hip arthroscopy can be used to evaluate disorders in the intra-articular region (central and peripheral compartments) and periarticular region (iliopsoas bursa and tendon disorders) as well as those in the peritrochanteric region.
髋关节疾病会使患者身体致残，对医生来说也是一项诊断挑战。利用磁共振成像（MRI）对髋关节进行成像的进展，有助于医生为急性或慢性髋关节疼痛患者确定更具体的诊断。MRI，尤其是磁共振关节造影，提高了人们对非关节炎性髋关节问题的认识，并使髋关节问题的诊断变得容易得多。MRI可以评估关节内和关节外的病变情况；有多种序列可供选择，以提高检测髋关节周围特定病变的敏感性和特异性。由于髋关节是位于大的软组织包膜内的深部关节，MRI通过评估髋关节周围的软组织和韧带结构，能更精确地描绘出髋关节疼痛的根源。了解MRI在评估髋关节内常见病理状况中的作用很有帮助，这些病理状况包括盂唇撕裂、软骨损伤、游离体、圆韧带撕裂、股骨髋臼撞击症、髋关节发育不良以及色素沉着绒毛结节性滑膜炎。髋关节镜检查是一种治疗髋关节问题的侵入性较小的技术，它也促使人们对这一骨科手术领域的兴趣迅速增长。髋关节镜检查可用于评估关节内区域（中央和周边间隙）、关节周围区域（髂腰肌滑囊和肌腱疾病）以及转子周围区域的疾病。
