Usefulness of MR Arthrography of the Hip with and without leg Traction in Detection of Intra-articular Bodies

Publication date: Available online 19 November 2018

Source: Academic Radiology

Author(s): F. Schmaranzer, T.D. Lerch, U. Strasser, P. Vavron, E. Schmaranzer, M. Tannast

Rationale and Objective

Although intra-articular bodies are a classic indication for MR arthrography and surgical removal, diagnostic studies are currently sparse. To assess the diagnostic performance of MR arthrography with and without leg traction in detection of intra-articular bodies in the hip joint.

Material and Methods

The institutional hip arthroscopy data base (2009–2016: 631 hips) was retrospectively reviewed. Inclusion criteria were hips with and without intra-articular bodies and direct MR arthrography performed with and without leg traction. Twenty-one hips with intra-articular bodies constituted the "disease-positive" group. Seventy-nine randomly selected hips without intra-articular bodies constituted the "disease-negative" group. Images were reviewed independently for presence of intra-articular bodies by two blinded readers. Overall diagnosis and location of intra-articular bodies was recorded (peripheral or central). Arthroscopy served as goldstandard for diagnosis and location of intra-articular bodies. Diagnostic performance and kappa statistics of traction MR arthrography with and without traction were calculated.

Results

For both readers sensitivity/specificity of traction MR arthrography was 86%–95% respectively 90%–91% for overall diagnosis of intra-articular bodies and was 81%–86% respectively 90%–92%for MR arthrogrpahy without traction. For central intra-articular bodies sensitivity was higher for both readers with traction (79%–89%) than without traction (74% each).

Conclusion

MR arthrography with and without traction of the hip is highly accurate in identifying central and peripheral intra-articular bodies. Application of traction was further useful for visualization of centrally located intra-articular bodies.

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