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Reports of magnetic resonance images of the hip in patients with femoroacetabular impingement: is useful information provided to the orthopedic surgeon?

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Abstract

Objective

The aim of this study was twofold: (1) To evaluate the quality of radiology reports of MR imaging/arthrography (MRI/MRA) of the hip performed on symptomatic young adults with suspected femoroacetabular impingement (FAI); and (2) to assess if MRI/MRA reports provide relevant information for surgical decision-making.

Materials and methods

We evaluated 110 MRI/MRA reports provided by 73 radiologists from 42 institutions. The images were requested preoperatively in young adults who underwent hip-preserving surgery for treatment of FAI. The quality of reports was graded using Lee’s method by two independent observers. The description of seven characteristics of the hip joint was scrutinized in order to assess if the reports contained relevant information for surgical decision-making.

Results

The quality of reports was Grade IIA in two cases (1.8 %), IIB in six (5.5 %), III in 60 (54.5 %), and IV in 42 (38.2 %). Relevant hip characteristics for the study of FAI were reported as follows: acetabular labrum (88.1 %), cartilage characteristics (69 %), morphology of the femoral head-neck junction (34.5 %), acetabular version (6.3 %), acetabular coverage (20.9 %), soft tissues description (82.7 %), and presence of bone marrow edema (80.9 %). The vast majority (91.8 %) of the reports described five or less relevant FAI characteristics.

Conclusions

Most of the radiology reports of MRI/MRA of the hip performed on symptomatic young adults with FAI were of the highest quality. However, some characteristics believed to be important for surgical decision-making in this particular group of patients were frequently not described. The inclusion of these hip joint characteristics in the radiology reports may improve the usefulness of the information provided to the orthopedic surgeon.

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References

  1. Dunnick NR, Langlotz CP. The radiology report of the future: a summary of the 2007 Intersociety Conference. J Am Coll Radiol. 2008;5(5):626–9.

    Article  PubMed  Google Scholar 

  2. Kahn CE Jr, Langlotz CP, Burnside ES, Carrino JA, Channin DS, Hovsepian DM, et al. Toward best practices in radiology reporting. Radiology. 2009;252(3):852–6.

    Article  PubMed  Google Scholar 

  3. European Society of Radiology. Good practice for radiological reporting. Guidelines from the European Society of Radiology (ESR). Insights Imaging. 2011;2(2):93–6.

    Google Scholar 

  4. Radiological Society of North America. RSNA Radiology Reporting Templates. http://www.radreport.org/. Accessed 21 Nov 2011.

  5. Lee R, Cohen MD, Jennings GS. A new method of evaluating the quality of radiology reports. Acad Radiol. 2006;13(2):241–8.

    Article  PubMed  Google Scholar 

  6. American Association of Orthopaedic Surgeons. Position Statement: In-Office Diagnostic Imaging Studies by Orthopaedic Surgeons. http://www6.aaos.org/news/PDFopen/PDFopen.cfm?page_url=http://www.aaos.org/about/papers/position/1132.asp. Accessed 21 Nov 2011.

  7. Haviv B, Burg A, Velkes S, Salai M, Dudkiewicz I. Trends in femoroacetabular impingement research over 11 years. Orthopedics. 2011;34(5):353.

    Google Scholar 

  8. Shetty VD. Persistent anterior hip pain in young adults: current aspects of diagnosis. Hip Int. 2008;18(1):61–7.

    PubMed  CAS  Google Scholar 

  9. Jaberi FM, Parvizi J. Hip pain in young adults: femoroacetabular impingement. J Arthroplasty. 2007;22(7 Suppl 3):37–42.

    Article  PubMed  Google Scholar 

  10. Troum OM, Crues JV, 3rd. The young adult with hip pain: diagnosis and medical treatment, circa 2004. Clin Orthop Relat Res. 2004;(418):9–17.

  11. Peters CL, Erickson J. The etiology and treatment of hip pain in the young adult. J Bone Joint Surg Am. 2006;88 Suppl 4:20–6.

    Article  Google Scholar 

  12. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540–52.

    Article  PubMed  Google Scholar 

  13. Smith TO, Hilton G, Toms AP, Donell ST, Hing CB. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol. 2011;21(4):863–74.

    Google Scholar 

  14. Zibis AH, Karantanas AH, Roidis NT, Hantes ME, Argiri P, Moraitis T, et al. The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol. 2007;63(1):3–9.

    Article  PubMed  Google Scholar 

  15. Mengiardi B, Pfirrmann CW, Hodler J. Hip pain in adults: MR imaging appearance of common causes. Eur Radiol. 2007;17(7):1746–62.

    Article  Google Scholar 

  16. Kassarjian A, Brisson M, Palmer WE. Femoroacetabular impingement. Eur J Radiol. 2007;63(1):29–35.

    Article  PubMed  Google Scholar 

  17. Yoon LS, Palmer WE, Kassarjian A. Evaluation of radial-sequence imaging in detecting acetabular labral tears at hip MR arthrography. Skeletal Radiol. 2007;36(11):1029–33.

    Article  PubMed  Google Scholar 

  18. Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE. Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology. 2005;236(2):588–92.

    Article  PubMed  Google Scholar 

  19. Rakhra KS. Magnetic resonance imaging of acetabular labral tears. J Bone Joint Surg Am. 2011;93 Suppl 2:28–34.

    Article  Google Scholar 

  20. Werlen S, Leunig M, Ganz R. Magnetic resonance arthrography of the hip in femoroacetabular impingement: technique and findings. Operative Techniques in Orthopaedics. 2005;15(3):191–203.

    Google Scholar 

  21. Fadul DA, Carrino JA. Imaging of femoroacetabular impingement. J Bone Joint Surg Am. 2009;91 Suppl 1:138–43.

    Article  PubMed  Google Scholar 

  22. Peters CL, Erickson JA, Anderson L, Anderson AA, Weiss J. Hip-preserving surgery: understanding complex pathomorphology. J Bone Joint Surg Am. 2009;91 Suppl 6:42–58.

    Article  PubMed  Google Scholar 

  23. Parvizi J, Campfield A, Clohisy JC, Rothman RH, Mont MA. Management of arthritis of the hip in the young adult. J Bone Joint Surg Br. 2006;88(10):1279–85.

    Article  PubMed  CAS  Google Scholar 

  24. Kim YJ, Ganz R, Murphy SB, Buly RL, Millis MB. Hip joint-preserving surgery: beyond the classic osteotomy. Instr Course Lect. 2006;55:145–58.

    PubMed  Google Scholar 

  25. Cohen SB, Huang R, Ciccotti MG, Dodson CC, Parvizi J. Treatment of femoroacetabular impingement in athletes using a mini-direct anterior approach. Am J Sports Med. 2012;40(7):1620–7.

    Google Scholar 

  26. ACGME. List of programs within a particular specialty for current academic year and those newly accredited programs with future effective dates (Year ending June 30th, 2012): Radiology-diagnostic. Accreditation Council for Graduate Medical Education. 2011. http://www.acgme.org/adspublic/. Accessed 23 Nov 2011.

  27. Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H. Improving communication of diagnostic radiology findings through structured reporting. Radiology. 2011;260(1):174–81.

    Google Scholar 

  28. Parvizi J, Leunig M, Ganz R. Femoroacetabular impingement. J Am Acad Orthop Surg. 2007;15(9):561–70.

    PubMed  Google Scholar 

  29. Pulido L, Parvizi J. Femoroacetabular impingement. Semin Musculoskelet Radiol. 2007;11(1):66–72.

    Article  PubMed  Google Scholar 

  30. Peters CL, Schabel K, Anderson L, Erickson J. Open treatment of femoroacetabular impingement is associated with clinical improvement and low complication rate at short-term followup. Clin Orthop Relat Res. 2010;468(2):504–10.

    Google Scholar 

  31. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84(4):556–60.

    Article  CAS  Google Scholar 

  32. Peters CL, Anderson LA, Erickson JA, Anderson AE, Weiss JA. An algorithmic approach to surgical decision making in acetabular retroversion. Orthopedics. 2011;34(1):10.

    PubMed  Google Scholar 

  33. Leunig M, Huff TW, Ganz R. Femoroacetabular impingement: treatment of the acetabular side. Instr Course Lect. 2009;58:223–9.

    PubMed  Google Scholar 

  34. Kain MS, Novais EN, Vallim C, Millis MB, Kim YJ. Periacetabular osteotomy after failed hip arthroscopy for labral tears in patients with acetabular dysplasia. J Bone Joint Surg Am. 2011;93 Suppl 2:57–61.

    Article  PubMed  Google Scholar 

  35. Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ, et al. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90 Suppl 4:47–66.

    Article  Google Scholar 

  36. Wassilew GI, Heller MO, Diederichs G, Janz V, Wenzl M, Perka C. Standardized AP radiographs do not provide reliable diagnostic measures for the assessment of acetabular retroversion. J Orthop Res. 2012;30(9):1369–76.

    Google Scholar 

  37. Mamisch TC, Zilkens C, Siebenrock KA, Bittersohl B, Kim YJ, Werlen S. MRI of hip osteoarthritis and implications for surgery. Magn Reson Imaging Clin N Am. 2010;18(1):111–20.

    Article  PubMed  Google Scholar 

  38. McGuire CM, Macmahon P, Byrne DP, Kavanagh E, Mulhall KJ. Diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography of the hip is dependent on specialist training of the radiologist. Skeletal Radiol. 2012;41(6):659–65.

    Article  PubMed  Google Scholar 

  39. Cohen MD. Accuracy of information on imaging requisitions: does it matter? J Am Coll Radiol. 2007;4(9):617–21.

    Article  PubMed  Google Scholar 

  40. Toomayan GA, Holman WR, Major NM, Kozlowicz SM, Vail TP. Sensitivity of MR arthrography in the evaluation of acetabular labral tears. AJR Am J Roentgenol. 2006;186(2):449–53.

    Article  PubMed  Google Scholar 

  41. Parmar VS, Stanitski DF, Stanitski CL. Interpretation of radiographs in a pediatric limb deformity practice: do radiologists contribute? J Pediatr Orthop. 1999;19(6):732–4.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. The Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Second Floor, Philadelphia, PA, 19107, USA

    Claudio Diaz-Ledezma, Marcelo Casaccia & Javad Parvizi

Authors
  1. Claudio Diaz-Ledezma
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  2. Marcelo Casaccia
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  3. Javad Parvizi
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Correspondence to Javad Parvizi.

Additional information

None of the authors has received funding from any institution for the preparation of this manuscript. The investigators retained full independence in the conduct of this research. One author (JP) certifies that he is a paid consultant for Biomet™, (Warsaw, Indiana), Smith & Nephew™ (Memphis, Tennessee) and Zimmer™ (Warsaw, Indiana), and has intellectual properties in SmarTech™ (Philadelphia, PA).

Each author certifies that his or her institution approved the human protocol for this investigation, and that all investigations were conducted in conformity with ethical principles of research.

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Diaz-Ledezma, C., Casaccia, M. & Parvizi, J. Reports of magnetic resonance images of the hip in patients with femoroacetabular impingement: is useful information provided to the orthopedic surgeon?. Skeletal Radiol 42, 335–340 (2013). https://doi.org/10.1007/s00256-012-1499-x

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