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Updated: Jun 26, 2025
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Comparison of 3T MR arthrography and 3T MRI in intra-articular hip pathology: a cost-analysis
David T Ryan1, Marion Hanley2, Annette White2
1Radiology Department, National Orthopaedic Hospital Cappagh, Dublin, Ireland. davidtryan@hotmail.com.
Background:
MR arthrography (MRA) has previously been the radiological gold standard for investigating labral and chondral lesions of the hip joint. In recent years, 3T MRI has demonstrated comparable accuracy, being adopted as the first-line imaging investigation in many institutions.
Aims:
We compare the associated increased cost and radiation dose of the fluoroscopic component of the MRA compared to MRI.
Methods:
In this retrospective review over 2 years, 120 patients (mean age 27.3 years ± 13.2, range 8-67) underwent 3T MRA or non-contrast 3T MRI. Three musculoskeletal radiologists reported the data independently. Primary objectives included cost-comparison between each and radiation dose of the fluoroscopic component of the MRA. Secondary objectives included comparing detection of pathology involving the acetabular labrum, femoral cartilage, and acetabular cartilage.
Results:
Then, 58 (48%) underwent 3T MRA and 62 (52%) patients underwent 3T MRI. The added cost of the fluoroscopic injection prior to MRA was €116.31/patient, equating to €7211.22 savings/year. MRA was associated with a small radiation dose of 0.003 mSv.
Conclusions:
Transitioning from 3T MRA to 3T MRI in the investigation of intra-articular hip pathology increases cost savings and reduces radiation dose.
Insights
Transitioning from MR arthrography (MRA) to 3T MRI for hip imaging saves money and reduces radiation exposure. This shift offers a more cost-effective and safer approach to diagnosing intra-articular hip pathology.
Area of Science:
- Orthopedic Imaging
- Musculoskeletal Radiology
- Diagnostic Imaging Techniques
Background:
- Historically, MR arthrography (MRA) was the gold standard for hip joint labral and chondral lesion evaluation.
- Advancements in 3T MRI have led to comparable diagnostic accuracy, establishing it as a preferred first-line imaging modality in many centers.
Purpose of the Study:
- To compare the financial costs associated with the fluoroscopic component of MRA versus 3T MRI.
- To evaluate and compare the radiation dose administered during the fluoroscopic-guided MRA procedure.
- To assess the diagnostic performance of both 3T MRA and non-contrast 3T MRI in detecting hip intra-articular pathologies.
Main Methods:
- Retrospective review of 120 patients (mean age 27.3 years) undergoing either 3T MRA or non-contrast 3T MRI over two years.
- Independent reporting by three musculoskeletal radiologists.
- Primary endpoints: cost comparison and radiation dose of MRA's fluoroscopic component; Secondary endpoints: detection rates of acetabular labrum, femoral cartilage, and acetabular cartilage pathology.
Main Results:
- Of 120 patients, 58 (48%) had 3T MRA and 62 (52%) had 3T MRI.
- The fluoroscopic injection for MRA incurred an additional cost of €116.31 per patient, resulting in annual savings of €7211.22 by avoiding this step.
- MR arthrography was associated with a minimal radiation dose of 0.003 mSv.
Conclusions:
- Shifting from 3T MR arthrography to non-contrast 3T MRI for evaluating intra-articular hip pathology leads to significant cost savings.
- This transition also effectively reduces patient radiation exposure.
- 3T MRI presents a more economical and safer alternative for hip imaging.
