High resolution noncontrast MRI of the hip

The relatively thin cartilage of the hip joint, as well as its complex geometry, poses challenges for standardized, reproducible assessment of cartilage and the acetabular labrum. With appropriate pulse sequence parameters, however, accurate, reproducible assessment of cartilage and the labrum is feasible. More detailed evaluation of cartilage biochemistry may be obtained with techniques aimed at noninvasively evaluating the integrity of collagen and/or proteoglycan components in the articular cartilage. One of the benefits of noncontrast techniques lie in the ability to visualize the native synovium, and thereby detect the presence of synovial proliferative disorders, the clinical symptoms of which may mimic a labral tear or traumatic cartilage injury. Standard cartilage evaluation allows for the detection of surface delamination and osteoarthritis in the setting of femoroacetabular impingement, as well as subtle areas of subchondral collapse and secondary delamination of cartilage in the setting of osteonecrosis. This preserves the use of hip arthroscopy as a therapeutic rather than a diagnostic tool.