Reason: right hip pain and difficulty walking after vaginal delivery 2/20 History: right hip pain and difficulty walking ACETABULAR LABRUM: Evaluation of the labrum is limited due to the lack of intra-articular contrast, however, there is a small focus of intermediate signal intensity within the acetabular labrum, anteriorly, between the 2 and 3 o'clock position, suggesting a small partial thickness undersurface tear. This is immediately beneath the crossing of the iliopsoas tendon raising the question of iliopsoas impingement.ARTICULAR CARTILAGE AND BONE: There is perhaps mild thinning of the articular cartilage along the posterior aspect of the acetabulum, but we see no focal fluid-filled articular cartilage defects. The bone marrow signal intensity of the proximal femur and acetabulum is normal. On the large field-of-view images, there is edema within the pubic symphysis and the bodies of the adjacent pubic bones which may represent trauma related to the patient's recent vaginal delivery. The symphyseal width is less than 5 mm, which is within normal limits. There is also a small 6 mm focus of fluid signal intensity beneath the body of the right pubic bone which may reflect a secondary cleft sign due to a small focal insertional adductor / pre-pubic aponeurotic complex tear, but the significance of this in the setting of recent childbirth is uncertain. This could be better evaluated with a pubalgia protocol MRI examination if clinically warranted. There is mild edema type signal within the medial aspect of the right ilium adjacent to the inferior portion of the right sacroiliac joint which may represent mild trauma following childbirth.SOFT TISSUES: There is low signal intensity debris within the endometrial cavity, presumably representing blood products.ADDITIONAL
1. Although the width of the pubic symphysis is within normal limits, there is a small amount of fluid within the symphysis extending into the prepubic aponeurotic complex suggesting aponeurotic injury although the clinical significance of this finding in the setting of recent vaginal delivery is uncertain.2. Small amount of edema within the right ilium adjacent to the right sacroiliac joint may also reflect mild trauma sustained with childbirth.3. Although the study is not optimal for evaluation of the acetabular labrum, there appears to be a small tear within the acetabular labrum beneath the iliopsoas tendon raising the possibility of iliopsoas impingement.