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“Anterior-shift sign”: a novel MRI finding of adult hip dysplasia

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In adult hip dysplasia, methods for direct evaluation of hip instability have not been established. The present study aimed to determine findings suggestive of hip instability on magnetic resonance imaging (MRI) and to evaluate their correlations with clinical and radiological factors.

Materials and methods

We retrospectively reviewed 72 hips in 50 patients with hip dysplasia (45 females, 5 males; mean age: 40.0 years; age range: 15–59 years; Kellgren–Lawrence grade: ≤ 2). Hip dysplasia was defined as a lateral center–edge angle < 25°. Among the hips, 50 had pain (symptomatic dysplasia group) and 22 were asymptomatic (asymptomatic dysplasia group). As controls, 12 normal hips in 12 patients who underwent screening for asymptomatic osteonecrosis of the femoral head by MRI were evaluated. Using an oblique axial view on fat-suppressed T2-weighted images, we evaluated the presence of a gap between the posterior part of the femoral head and the corresponding acetabular surface, indicating hip instability (anterior-shift sign). The correlations of anterior-shift sign with clinical and radiographical factors were examined.

Results

Anterior-shift sign was observed in 92.0% in the symptomatic dysplasia group, 9.1% in the asymptomatic dysplasia group, and 0% in the control group. In adult hip dysplasia, cases with anterior-shift sign had significantly more pain and labrum tear occurrence than cases without anterior-shift sign. Anterior-shift sign was correlated with Kellgren–Lawrence grade and degree of acetabular coverage.

Conclusions

This study suggested that hip instability can be observed as the anterior-shift sign on MRI. This sign is useful when considering indications for periacetabular osteotomy in adult hip dysplasia.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, 820-8505, Japan

    Kazuhiko Sonoda & Toshihiko Hara

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  1. Kazuhiko Sonoda
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  2. Toshihiko Hara
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Correspondence to Kazuhiko Sonoda.

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The institutional review board approved this study (Number 20060–752).

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Sonoda, K., Hara, T. “Anterior-shift sign”: a novel MRI finding of adult hip dysplasia. Arch Orthop Trauma Surg 142, 1763–1768 (2022). https://doi.org/10.1007/s00402-021-03808-0

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  • DOI: https://doi.org/10.1007/s00402-021-03808-0

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