Are radiographic trochanteric surface irregularities associated with abductor tendon abnormalities?

Area of Science:

• Radiology
• Orthopedic Imaging
• Musculoskeletal Imaging

Background:

• Abductor tendon abnormalities are a common cause of hip pain.
• Conventional radiographs are widely available for hip imaging.
• Magnetic resonance (MR) imaging provides detailed soft tissue visualization.

Purpose of the Study:

• To determine the association between trochanteric surface irregularities on conventional radiographs and MR evidence of abductor tendon abnormalities.
• To evaluate the diagnostic utility of radiographic findings for detecting hip abductor tendon pathology.

Main Methods:

• Retrospective analysis of 150 hip radiographs and MR images.
• Independent review of radiographs and MR images by two readers.
• Grading of trochanteric surface irregularities (normal, 1-2 mm, >2 mm) and abductor tendon status (normal, tendinopathy, partial/full tear).

Main Results:

• Surface irregularities >2 mm on radiographs had a 90% positive predictive value for MR-detected tendinopathy or tears.
• Radiographic findings showed 40% sensitivity and 94% specificity for abductor tendon abnormalities.
• Interobserver agreement for detecting radiographic irregularities varied (κ = 0.28–0.76).

Conclusions:

• Significant (>2 mm) greater trochanter surface irregularities on conventional radiographs are associated with abductor tendon abnormalities visualized on MR imaging.
• Conventional radiography may serve as a screening tool for potential abductor tendon pathology.