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Sonography of the acetabular labrum: visualization of labral injuries during intra-articular injections
Carolyn M Sofka1, Ronald S Adler, Martha A Danon
1Department of Radiology and Imaging, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA. sofkac@hss.edu
Objective:
The purpose of this series was to describe the improved conspicuity in the sonographic appearance of acetabular labral injuries during routine sonographically guided intra-articular injections.
Methods:
Sonographic examinations of patients undergoing routine sonographically guided intra-articular hip injections were reviewed for evidence of labral injuries (n=21). Sonographic examinations were then correlated with magnetic resonance images of the ipsilateral hip when available (n=14).
Results:
Before injection, 13 acetabular labra had linear or irregular hypoechoic clefts or fissures through the normally hyperechoic fibrocartilaginous labrum, thought to represent tears. Eight of the labra showed a more globular alteration in morphologic characteristics, with diffuse thickening and irregularity. During intra-articular injection, the visualized injected fluid outlined the labrum, yielding a "sonoarthrographic effect," providing a fluid interface along the labral boundaries, and confirming the presence of a tear by imbibition of injected material into the defect with a resultant subjective improvement in the labral injury.
Conclusions:
Evaluating the labrum after injection may improve visualization of labral injuries, as a result of greater labral conspicuity.
