Extract
While magnetic resonance imaging remains a standard tool in the radiologic diagnosis of disorders about the hip joint, challenges remain with regard to assessment of cartilage damage secondary to the spherical contour of the joint and relative thinness of the articular cartilage. Despite these difficulties, magnetic resonance arthrography is the recommended study for the assessment of chondral and labral pathology of the hip. Magnetic resonance imaging technology will benefit from increased field strength, improved coils, and the development of fast isotropic high-resolution sequences. These improvements will allow detection of subtle cartilage abnormalities. Additionally, continued technical improvements should allow practical application of both noncontrast and contrast-enhanced biochemical imaging techniques.
While magnetic resonance imaging remains a standard tool in the radiologic diagnosis of disorders about the hip joint, challenges remain with regard to assessment of cartilage damage secondary to the spherical contour of the joint and relative thinness of the articular cartilage. Despite these difficulties, magnetic resonance arthrography is the recommended study for the assessment of chondral and labral pathology of the hip. Magnetic resonance imaging technology will benefit from increased field strength, improved coils, and the development of fast isotropic high-resolution sequences. These improvements will allow detection of subtle cartilage abnormalities. Additionally, continued technical improvements should allow practical application of both noncontrast and contrast-enhanced biochemical imaging techniques.
Current research utilizing delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), which measures loss of glycosaminoglycans in early stages of arthritis, has demonstrated that dGEMRIC has the ability to detect early stages of osteoarthritis due to hip dysplasia and femoroacetabular impingement. The dGEMRIC index correlates better with clinical pain scores than does measurement of joint-space narrowing on plain-film radiographs, which suggests that this magnetic resonance imaging technique may be a valid tool in the assessment of prearthritic hips1. Additionally, follow-up studies after periacetabular osteotomy for hip dysplasia demonstrated that the preoperative dGEMRIC index is the best predictor of outcome2. This further supports the notion that dGEMRIC is a valid metric for the assessment of early stages of osteoarthritis.
Computer-assisted hip navigation continues to have limited acceptance in traditional total hip arthroplasty surgery. Newer techniques of minimally invasive surgery and hip resurfacing have been supported by computer-assisted navigation, which improves accuracy and precision during placement of acetabular and femoral components. Complementing this goal of implant placement optimization, current clinical research software permits surgeons to compare native hip range of motion with the kinematics achieved following hip arthroplasty surgery. Future trends in computer-assisted surgery of the hip will incorporate technology as a tool for research, surgeon education, and improved patient outcomes. 
Kim Y-J, Jaramillo D, Millis MB, Gray ML, Burstein D. Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage. J Bone Joint Surg Am.2003;85:1987-92.851987
2003
[PubMed]
Cunningham T, Jessel R, Zurakowski D, Millis MB, Kim Y-J. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage to predict early failure of Bernese periacetabular osteotomy for hip dysplasia. J Bone Joint Surg Am.2006;88:1540-8.881540
2006
[CrossRef]