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Chondral and Osteochondral Abnormalities, Hip
MK Jesse, MD; Julia R. Crim, MD; Adam C. Zoga, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Chondral defect or fracture: focal injury to cartilage
                • Term should not be used for widespread cartilage damage, which indicates osteoarthritis
              • Osteochondral defect or fracture: focal injury to cartilage and underlying bone
              • Osteochondritis dissecans (OCD): chronic osteochondral injury, typically from overuse
                • Rare in hip
              • Chondral delamination: partially detached cartilage flap tear
                • Cartilage remains attached to adjacent cartilage on at least 1 margin
              • Contrecoup: injury to posterior cartilage caused by anterior impingement
              • Iatrogenic cartilage injury: occurs following arthroscopy

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Reporting Tips

                                      Selected References

                                      1. Nakano N et al: Outcomes of cartilage repair techniques for chondral injury in the hip-a systematic review. Int Orthop. 42(10):2309-22, 2018
                                      2. Crim J: Imaging evaluation of the hip after arthroscopic surgery for femoroacetabular impingement. Skeletal Radiol. 46(10):1315-26, 2017
                                      3. Mills MK et al: Postoperative imaging in the setting of hip preservation surgery. Radiographics. 36(6):1746-58, 2016
                                      4. Sutter R et al: Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol. 202(1):160-9, 2014
                                      5. Byrd JW: Supraacetabular fossa. Radiology. 265(2):648; author reply 648, 2012
                                      6. Dietrich TJ et al: Supraacetabular fossa (pseudodefect of acetabular cartilage): frequency at MR arthrography and comparison of findings at MR arthrography and arthroscopy. Radiology. 263(2):484-91, 2012
                                      7. Marshall N et al: Traumatic injuries of the hip. Magn Reson Imaging Clin N Am. 17(4):681-96, vi, 2009
                                      8. Philippon MJ et al: Arthroscopic findings following traumatic hip dislocation in 14 professional athletes. Arthroscopy. 25(2):169-74, 2009
                                      9. Sekiya JK et al: Arthroscopic repair of delaminated acetabular articular cartilage in femoroacetabular impingement. Orthopedics. 32(9), 2009
                                      10. Zaragoza E et al: Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. Hip Int. 19(1):18-23, 2009
                                      11. Studler U et al: MR arthrography of the hip: differentiation between an anterior sublabral recess as a normal variant and a labral tear. Radiology. 249(3):947-54, 2008
                                      12. Tannast M et al: Hip damage occurs at the zone of femoroacetabular impingement. Clin Orthop Relat Res. 466(2):273-80, 2008
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Chondral defect or fracture: focal injury to cartilage
                                                    • Term should not be used for widespread cartilage damage, which indicates osteoarthritis
                                                  • Osteochondral defect or fracture: focal injury to cartilage and underlying bone
                                                  • Osteochondritis dissecans (OCD): chronic osteochondral injury, typically from overuse
                                                    • Rare in hip
                                                  • Chondral delamination: partially detached cartilage flap tear
                                                    • Cartilage remains attached to adjacent cartilage on at least 1 margin
                                                  • Contrecoup: injury to posterior cartilage caused by anterior impingement
                                                  • Iatrogenic cartilage injury: occurs following arthroscopy

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Nakano N et al: Outcomes of cartilage repair techniques for chondral injury in the hip-a systematic review. Int Orthop. 42(10):2309-22, 2018
                                                                          2. Crim J: Imaging evaluation of the hip after arthroscopic surgery for femoroacetabular impingement. Skeletal Radiol. 46(10):1315-26, 2017
                                                                          3. Mills MK et al: Postoperative imaging in the setting of hip preservation surgery. Radiographics. 36(6):1746-58, 2016
                                                                          4. Sutter R et al: Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol. 202(1):160-9, 2014
                                                                          5. Byrd JW: Supraacetabular fossa. Radiology. 265(2):648; author reply 648, 2012
                                                                          6. Dietrich TJ et al: Supraacetabular fossa (pseudodefect of acetabular cartilage): frequency at MR arthrography and comparison of findings at MR arthrography and arthroscopy. Radiology. 263(2):484-91, 2012
                                                                          7. Marshall N et al: Traumatic injuries of the hip. Magn Reson Imaging Clin N Am. 17(4):681-96, vi, 2009
                                                                          8. Philippon MJ et al: Arthroscopic findings following traumatic hip dislocation in 14 professional athletes. Arthroscopy. 25(2):169-74, 2009
                                                                          9. Sekiya JK et al: Arthroscopic repair of delaminated acetabular articular cartilage in femoroacetabular impingement. Orthopedics. 32(9), 2009
                                                                          10. Zaragoza E et al: Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. Hip Int. 19(1):18-23, 2009
                                                                          11. Studler U et al: MR arthrography of the hip: differentiation between an anterior sublabral recess as a normal variant and a labral tear. Radiology. 249(3):947-54, 2008
                                                                          12. Tannast M et al: Hip damage occurs at the zone of femoroacetabular impingement. Clin Orthop Relat Res. 466(2):273-80, 2008