Presentation
Anterior and lateral hip pain
Patient Data
Cystic-like region extending from the anterior left hip joint labrum favored to be a paralabral cyst due to a labral tear. No hip joint effusion.
Fluoroscopic guided left hip arthrogram injection. Injection of iodinated contrast confirms an intra-articular needle tip position. The final image is taken after the MRI arthrogram solution is given.
Chondrolabral separation of the left hip anterosuperior labrum, with associated paralabral cysts that extend superiorly, and both medial and lateral to the iliopsoas tendon. No chondral loss. Narrowing of the ischiofemoral intervals.
Case Discussion
Although ultrasound can identify paralabral cysts, it is MRI that should be used to confirm and fully assess labral issues. As is often the case and shown here, the gadolinium solution doesn't extend into the paralabral cyst, and it is easier to identify on the fluid-sensitive sequences. Wide field of view imaging should be included in arthrogram protocols to identify other issues, such as narrowing of the ischiofemoral intervals.