Anterior Hip

Abstract

With improved resolution at increased depths, ultrasound helps assess hip pathology, including effusion and synovitis. The anterior recess, just distal to the hip joint itself, is a common location for hip aspiration and injection. The recess reflects pathology in the hip joint, including effusion and synovitis from inflammatory disease. Iliopsoas bursitis superficial to the anterior recess occurs with inflammatory diseases, infection, or overuse. Ultrasound may detect hip labrum abnormalities but is not as specific as a magnetic resonance arthrogram. Dynamic ultrasound may demonstrate labrum impingement with femoral acetabular impingement. Ultrasound is helpful for the evaluation of pain after total hip arthroplasty. It can detect fluid collections that might indicate surrounding abscess formation. The examiner may assess the gluteus tendons to look for causes of post-hip replacement pain, particularly in those patients whose surgeons took an anterolateral approach. An extra-articular medial snapping hip in which the psoas major tendon is impinged by muscle can be demonstrated dynamically. The clinician may use ultrasound to demonstrate rectus femoris tendon or muscle tears. Compression of the lateral femoral cutaneous nerve under the inguinal ligament may produce bothersome symptoms of meralgia paresthetica; ultrasound can make the diagnosis and precisely guide an injection for relief. Inguinal lymph nodes are assessed for structural abnormalities that may suggest malignancy.

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