Hip MRI

When is an MRI of the Hip Recommended? 

Hip MRI is a radiology imaging examination used to diagnose a complaint or symptom. In Colorado’s active population, hip complaints are common from trauma, overuse, and arthritis. Your clinician may order an MRI to evaluate hip pain after sudden trauma like an accident or sports injury. 

MRI is also used to evaluate long-standing complaints such as arthritis. The technology can evaluate fluid in the joint easily and even distinguish whether that fluid represents blood (called hemarthrosis) or inflammation (called bursitis). 

• MRI can also be used to get a better look at a finding discovered by an x-ray. 

As we get older, degenerative joint disease (arthritis) can cause chronic hip pain. Not all arthritis is from wear and tear. Some conditions of hip pain are because of inflammatory arthritis. The inflammation in the joint space causes pain and swelling and may cause destruction of the hip joint over a long period of time. Examples of this include rheumatoid arthritis and psoriatic arthritis. 

Degenerative arthritis (from wear and tear) and fractures of bones (from trauma) can be best evaluated with regular x-rays first. If the plain x-rays explain why you are having pain, then your physical therapist or orthopedic surgeon may not pursue further MRI imaging. 

• However, sometimes your symptoms suggest there is still a problem that is invisible with standard medical diagnostic imaging. In this case, your clinician will order an MRI of the hip to better visualize and evaluate the components within the joint and soft tissues. MRI of the hip can provide more detailed imaging. 

Subtle injuries of the hip may involve the cartilage (the slippery protective covering of the federal head and the acetabulum. Sometimes, the cushion between the bones of the hip called the acetabular labrum can tear. A part of the folded labrum or fragment of it may produce a clicking or catching sensation or pain when you walk or run. With major sports injuries, the ligaments (fibrous bands that connect the bones of the hip joint) or the tendons (fibrous collagen that connects the bones to the muscles of the hip) can be sprained or torn in some cases. 

• A specific type of hip injury from trauma or overuse that affects the vascular supply of the bone is called avascular necrosis is also best evaluated by MRI. This condition can be seen in runners and with long-term corticosteroid use.

MRI is also used to diagnose a medical condition and help plan for treatment. MRI can determine whether an acute (sudden) or long-standing (chronic) labrum cartilage tear may be the cause of pain for an athlete. If a tear is identified within the hip joint, the MRI can provide details on the severity of the tear. The MRI scan images give an orthopedic surgeon a more detailed map to use if surgery is indicated. 

What is the Anatomy of the Hip? 

The hip is a “ball and socket” joint that allows for great rotation. The main articulating bones are the femoral head (the ball) that articulates with the acetabulum (the socket and a part of the pelvis). 

• The other bones that make up the hip are contiguous with the pelvis including the greater trochanter, lesser trochanter, ischium, and ilium. 

The strength of the hip comes from the muscles that make up the hip and strong ligaments. The iliofemoral ligament is the strongest ligament in the body. The muscles are divided up into groups that allow different movements and forces.

What is a Hip MRI? 

Magnetic Resonance Imaging (MRI for short) is a medical diagnostic imaging technology that uses magnets and radio waves to produce detailed 3-D imaging of the hip and joint. These signals are then converted to medical diagnostic images for the radiologists to interpret. 

MRI can be performed to distinguish normal tissues from injured or pathologic (abnormal) tissues. 

MRI can be used as a diagnostic scan to diagnose tumors. If a tumor is suspected based on your symptoms, an oncologic orthopedic surgeon who specializes specifically in tumors of the bones, joints, and supporting soft tissues may order a specific type of hip MRI. The tumor MRI protocol usually requires intravenous contrast to show vessels. Your MRI technologist will explain what protocol is indicated.  

How to Prepare Ahead of Time: 

You will be asked to complete the medical history of any underlying medical conditions. Please tell the scheduler and the technologist if you have any metal in your body such as metal fragments from trauma or surgery that may be an issue for the “magnetic pull” of the MRI. 

Tell us if you have had any surgery or other procedures anywhere on your body including your limbs, abdomen, brain, or heart. 

If you have any implanted devices such as pacemakers, defibrillators, aneurysm clips, auditory hearing implants, neurotransmitters, internal wires or electrodes, implanted pumps or ports, surgical mesh, any coils, stents, or filters please tell your technologist before scheduling because an MRI may not be possible. 

• Many cardiac pacemakers and defibrillators are not compatible with MRI. Some of the newer devices are so it is important to know from your surgeon and the manufacturer what kind you have. 

Some external body wear or designs such as body or face/ makeup tattooing, and permanent piercings may limit you from having the MRI. Current or prior metal workers may have small fragments in their eyes as an occupational hazard. You may be asked to have an x-ray prior to performing the MRI. Jewelry and piercings need to be taken out by you for your safety in the magnet. Please see our MRI SAFETY FORM for more information. Please download the Questionnaire and Consent Forms under the Resources Tab on the front home page. 

How is a Hip MRI Performed?

You will be lying on your back on a comfortable table that your MRI technologist moves into and out of the machine. The magnet makes a loud clunky sound so the technologist will fit you with headphones and you may choose to listen to music through the headphone that makes the magnet sound indistinct. Many patients actually find the MRI scan soothing because of the music and may fall asleep. 

• It is important not to move quickly or jerk during the exam because this may cause irregularities in the images from signals of the magnets moving. 

The MRI scan imaging time may take 25 -35 minutes depending on whether special imaging sequences or contrast administration are needed. The indication for the study may affect the time needed to perform the hip imaging scan. 

How Do I Obtain My Results? 

Hundreds of MRI images of the pelvis in various sequences will be produced for each radiology imaging scan that needs to be interpreted. Therefore, the results will not be immediately available. An “MRI near me“ search will show you we are here locally to handle your needs. We will call you regarding your results once the interpretation is complete. If you have any prior examinations elsewhere, please let us know the location so that we can obtain these for faster comparison. The images from many centers can be transferred to The Women’s Imaging Center quickly. You might have to sign a release form so that we may request this transfer. We will also send a copy of your report to your ordering clinician and they will discuss any further action recommended based on your radiology imaging results.