Comprehensive approach of Plain Radiography and Magnetic Resonance Imaging in the evaluation of Painful Hip Joint-A Cross Sectional Study

The hip is classified as a ball-and-socket type synovial joint which connects the acetabulum to the femoral head. Because of the architecture & direction of the hip joint ,it is critical to pinpoint the exact location of illness in order to provide an accurate diagnosis of the primary disease & to rule out subsequent involvement of surrounding structures.

The imaging of the hip was one of the first applications of musculoskeletal magnetic resonance imaging .As,it helps in evaluation of articular structures, extra articular soft tissues & osseous structures that could be impacted by hip disease , Magnetic resonance(MR) imaging has proved to be a significant tool for evaluating hip problems.

A normal appearing radiograph, a vague history & clinical symptoms in a case of chronic hip pain might be a challenging diagnostic issue. Infection , arthritis , trauma , avascular necrosis(AVN)& hip dysplasia can all cause radiographic deformity that are extremely modest.

Presently , the best method to evaluate intra-articular disease is to use high resolution direct MRI. Radiographyis still useful for detecting small bone anomalies related to femoroacetabular impingement.

In individuals having musculoskeletal complaints , MRI reveals marrow and soft tissue abnormalities that are missing on radiographs of sarcoidosis.

The primary advantage of genuine coronal & axial planes is that they provide symmetric, bilateral pictures which can help with diagnosis & reduce the time it takes to analyse both hips. On coronal & axial MR images , normal hip architecture is easily seen. On coronal MR images, the femoral head & neck and intertrochanteric region are best appreciated. The articular space , hip musculature & supporting ligaments can all be seen clearly on axial MR images.

MR imaging is used to detect AVN in its early phases allowing for more effective treatment & prevention of bone deterioration. The most sensitive technique for imaging AVN has found to be MRI. The primary purpose of MR imaging is to make a diagnosis of AVN in symptomatic individuals before radiographic alterations become apparent.

In the diagnosis & treatment of paediatric hip problems , MR imaging is becoming increasingly important.Other imaging modalities like plain radiography , Computed tomography(CT)&Ultrasonography(USG) are rarely employed since majority of the paediatric hip is cartilaginous. Because of its capacity to reveal cartilage , MR imaging is the only best method for paediatric hip imaging.

Normal growth of the juvenile hip is based on correct seating of femoral head in acetabulum . With multiplanar MR imaging , the shape & position of femoral head can be properly examined. Furthermore , MR imaging allows for direct visualization of changes in bone marrow , which is not feasible with US or CT imaging.

In examination of arthritis and infective illnesses such as TB where early radiographic signs may be modest , MR imaging has become increasingly essential.

Radiography is the primary tool for studying the hip joint.  To visualise a painful hip joint, many X-ray projections have been developed. Anteroposterior view is the typical X-ray view. It aids in evaluating acetabular integrity and joint space.

MRI is the most commonly used modality for hip joint discomfort due to its strong soft tissue contrast and greater resolution, depicting remarkable anatomical information. It not only provides the precise location of the pathology but also the correct diagnosis of the primary illness & aids in identifying secondary involvement of nearby tissues. Thus, it will significantly affect patients’ treatment plans and will be a helpful tool for doctors, particularly when radiography and first-line therapeutic care have not been successful.

This study is being done to prove that currently the best method for assessing intra articular hip disease is  MR imaging but for the diagnosis of minute bony anomalies linked to femoroacetabular impingement , plain radiography is crucial .Therefore , a comprehensive imaging strategy requires conventional radiographs and MRI to evaluate intra- and extra-articular sources of pain. Very few studies have been done in this region on this topic.