Reason: eval for acetabular fx or other hip pathology History: acute on subactue left hip pain, MVA one month ago, unable to bear weight Bone marrow signal is within normal limits. There is no evidence of acute fracture. Alignment is anatomic. There is moderate osteoarthritis of left hip including moderate osteophytes and joint space narrowing.Within the limitations of a non-arthrographic study, there is abnormal T2 signal hyperintensity undercutting the anterior superior aspect of the acetabular labrum, which may reflect a tear (series 9, image 9). Additionally, there is a circumscribed, ovoid, T2 hyperintense cystic lesion anterior to the hip joint which appears to communicate with the joint capsule measuring up to 2 cm, which is nonspecific but may reflect a paralabral cyst. There is no significant joint effusion. No abnormal enhancement is identified.There is mild T2 signal hyperintensity within the gluteus musculature near the attachment on the greater trochanter, particularly the gluteus medius and minimus, compatible with mild strain. There is trace fluid in the trochanteric bursa without specific evidence of bursitis.There is no acute intrapelvic abnormality identified.Moderate to marked osteoarthritis affects the right hip and there are degenerative changes at the pubic symphysis and lower lumbar spine. There is cortical thickening and trabecular irregularity of the right hemipelvis as seen on the coronal T1, which suggests Paget's disease, as seen on previous bone scan/CT.
1.Moderate osteoarthritis of the hips without acute fracture or malalignment.2.Questioned anterior superior labral tear with possible paralabral cyst anterior to the hip joint. Consider dedicated arthrographic study as clinically indicated.3.Mild strain of the gluteus musculature.