Diagnostic tests
1st tests to order
1st tests to ordertable-forGroin pain
| Test | Result |
- plain x-rays (AP pelvis and AP and lateral hip)
-
First-line imaging study.
Should be obtained following initial evaluation for most acute and chronic presentations of hip pain.
| signs of femoroacetabular impingement (FAI) or dysplasia, including cam and pincer impingement; abnormal bone morphology; also shows fracture; dislocation, degenerative joint space narrowing, arthritic changes, lytic or destructive bony lesions |
Tests to consider
Tests to considertable-forGroin pain
| Test | Result |
- ultrasound of the hip
-
Real-time examination, making it possible to combine imaging with movement, palpation, and tenderness. Very helpful with therapeutic or diagnostic injections.
| soft-tissue injuries and other changes, inflammation (with Doppler), bursitis, tendinopathy, enthesopathy, snapping tendon, hip joint effusion, pathology in or around the inguinal canal |
- MRI of the hip
-
Study of choice for diagnosing or excluding stress fractures, osteomyelitis, or early-stage osteonecrosis. The reported sensitivity of this modality has varied widely (47% to 91%).
Clinical correlation is vital.
Labral pathology may be incidental finding.
| soft-tissue injuries, bone abnormalities including malignancy, and stress fracture |
- MRI arthrogram of the hip
-
Most sensitive non-invasive test available to identify labral tears.
| intra-articular pathology including labral, cartilage, and ligamentum teres pathology |
- CT of the hip
-
Study of choice for demonstrating bony anatomy of the pelvis and proximal femur in the setting of fracture, dislocation, or osseous lesion.
| fractures, dislocation, or infiltrative bone lesions |
- isotope bone scan of the hip
-
Sensitive but non-specific measure of abnormal metabolic activity in the setting of infectious, repair, inflammatory, or malignant process.
Can in some cases be used as an alternative to MRI or CT if these are contraindicated or not available.
| increased uptake of isotope in case of increased metabolic uptake, reflecting a number of entities |
- intra-articular injection corticosteroid ± local anaesthetic agent
-
Only intra-articular lesions will have relief from this therapeutic trial.
Should only be performed under image guidance by trained radiologist or orthopaedic surgeon.
| subjective pain relief |
Last updated: Sep 17, 2012
