58F Chronic Refractory Hip Pain

There is G Minimus Tendinosis and High grade insertional tear with contiguous partial tear of the Vastus Lateralis. This looks similar to the contiguous delaminating type tear we see in athletic pubalgia at the Rectus Abdominis-Adductor Longus aponeurosis.  Is there a common aponeurosis in this location?  I've seen this many times.

31M 6 months right hip and groin pain...what do you think?

There is a large CAM lesion with deep chondral fissuring at the anterosuperior chondrolabral junction and tearing of the anterosuperior labrum.

My question is about the secondary cleft at the pubic symphysis, incompletely imaged at the medial margin of the FOV. Is there are reason to recommend pelvis MRI with pubalgia protocol, or do we have enough information to report partial tearing along the origin of the right sided adductor longus?

 

 

43F 18 years worsening hip pain referrered for evaluation of FAI

Femoral head lesion

F 62, left hip pain. Suspected impingement.

There's a subchondral / subcortical bone lesion at the anterior aspect of the left femoral head with cystic and fatty components, possibly also some calcification.

To me it doesn't look like a typical impingement lesion / herniation pit.

More like cystic degeneration of an intraosseous lipoma, or an LSMFT. 

She also has cartilage changes with subchondral cysts and mild trochanter bursitis (not shown).

What is your impression?

 

Distal Cam lesion in 46F with hip pain

The Cam lesion is distal (white arrow), not where we expect a Cam related to FAI.  This has been reported to correlate with symptoms of Subspine Impingement (SSI) even when the AIIS is not elongated (which it is not in this case).  There is anterosuperior labral tear (yellow arrows)...which begs the question what has caused it in this case (and the majority of cases like this in the reference). If there's symptomatic impingement of any type (and a pulse and active insurance) I suppose this Cam bump will be excised.  What are your thoughts about this?  Do you buy it????/

https://pubs.rsna.org/doi/10.1148/radiol.2019190581

Femoral head lesion

F 62, left hip pain. Suspected impingement.

There's a subchondral / subcortical bone lesion at the anterior aspect of the left femoral head with cystic and fatty components, possibly also some calcification.

To me it doesn't look like a typical impingement lesion / herniation pit.

More like cystic degeneration of an intraosseous lipoma, or an LSMFT.

She also has chondropathy with subchondral cysts and mild trochanter bursitis (not shown).

What is your impression?

Thanks,

Andrei

P.S.
I wanted to add a comment to my own post but it seems that's not possible.
As far as I can tell, one can only insert images or videos, no way to attach a powerpoint, pdf etc. If that's correct it would in my opinion be a severe limitation.

20-year-old woman with hip pain

AP view of the right hip

Frog-leg lateral view of the right hip

Zoomed-in view of the frog-leg lateral view

Coronal T1-WI

Coronal T2-WI with FS

Axial T1-WI with FS and contrast

Diagnosis: Plexiform neurofibroma with intra- and extra-articular components

H&E stain showing neurofibromas (*)