The Current State of Hip Imaging

Imaging assessment of the hip demands detailed anatomic knowledge and precise recognition of characteristic injury patterns. This chapter first describes osseous pathology—including fatigue and insufficiency stress injuries, osteonecrosis, and subchondral insufficiency fracture—emphasizing early MRI hallmarks and radiographic staging. Additionally, mechanisms of osseous conflict are detailed, notably cam- and pincer-type femoroacetabular impingement and pathologic femoral antetorsion. Intraarticular derangements of the acetabular labrum, articular cartilage, capsule, and ligamentum teres are described. And finally, extraarticular types of impingement are discussed, encompassing subspine impingement, iliopsoas impingement, ischiofemoral impingement, and deep gluteal syndrome. Throughout, imaging findings are integrated with clinical context to guide conservative care, hip-preserving procedures, and total hip arthroplasty planning.