Imaging of hip and pelvis injuries

It is extremely important to provide the interpreting radiologist with a detailed and accurate history in order to avoid under-appreciation of subtle findings on the requested study. When interpreting plain radiographs, do not focus just on the femoral head and hip joints. The scan must also include the sacroiliac joints, lumbar spine, pubic symphysis, obturator foramen, and adjacent soft tissues as well. If intra-articular pathology is suspected, the magnetic resonance imaging (MRI) should be performed on a high field system with a narrow field of view (as opposed to an open low field magnet). Magnetic resonance arthrography (MRA) is the preferred method of assessment of cartilage pathology in the hip joint. Stress fractures present on MR as a linear band of signal replacing normal bone marrow. If femoroacetabular impingement (FAI) is suspect, radiography should include a cross-table lateral view.