Reason: severe left hip pain s/p fall; x-ray shows OA; missed fracture or labral tear? History: severe left hip pain s/p fall; x-ray shows OA; missed fracture or labral tear? ACETABULAR LABRUM: There is heterogeneity and intermediate signal intensity within the superior, anterior, and posterior labrum likely representing a combination of degeneration and degenerative tearing.ARTICULAR CARTILAGE AND BONE: There is increased bone marrow signal abnormality on fluid sensitive sequences within the intertrochanteric, subtrochanteric, and proximal metadiaphysis of the left femur. There is equivocal linear decreased signal abnormality within the intertrochanteric region of the left femur. No definite cortical disruption is identified. There is extensive inflammatory changes in the surrounding soft tissues. There is articular cartilage degeneration and osteophyte formation indicating moderate to severe osteoarthritis of the left hip.SOFT TISSUES: There is inflammatory change in the soft tissues about the trochanteric region of the left femur. There is partial thickness tearing of the hamstring tendon at the level of its origin on the initial tuberosity. There is no significant retraction. There is small interstitial tearing of the left gluteus medius muscle at the level of the myotendinous junction. ADDITIONAL
Extensive bone marrow signal abnormality within the left femur with nonspecific soft tissue inflammatory change as described above. These findings may represent a large bone infarction, although there is equivocal linear signal abnormality in the intertrochanteric region of the left femur raising the possibility of a nondisplaced fracture. CT examination is recommended to further evaluate for the possibility of fracture. A medullary process such as osseous metastatic disease cannot be completely excluded by this noncontrast examination, particularly in the setting of a known primary malignancy, but this is felt to be less likely. Other findings as described above.