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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:1321-1326 • 0278-4297

Case Series

Sonography of the Acetabular Labrum

Visualization of Labral Injuries During Intra-Articular Injections

Carolyn M. Sofka, MD, Ronald S. Adler, PhD, MD and Martha A. Danon, MD

Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York USA.

Address correspondence to Carolyn M. Sofka, MD, Department of Radiology and Imaging, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021 USA. E-mail: sofkac{at}hss.edu

Objective. The purpose of this series was to describe the improved conspicuity in the sonographic appearance of acetabular labral injuries during routine sonographically guided intra-articular injections. Methods. Sonographic examinations of patients undergoing routine sonographically guided intra-articular hip injections were reviewed for evidence of labral injuries (n = 21). Sonographic examinations were then correlated with magnetic resonance images of the ipsilateral hip when available (n = 14). Results. Before injection, 13 acetabular labra had linear or irregular hypoechoic clefts or fissures through the normally hyperechoic fibrocartilaginous labrum, thought to represent tears. Eight of the labra showed a more globular alteration in morphologic characteristics, with diffuse thickening and irregularity. During intra-articular injection, the visualized injected fluid outlined the labrum, yielding a "sonoarthrographic effect," providing a fluid interface along the labral boundaries, and confirming the presence of a tear by imbibition of injected material into the defect with a resultant subjective improvement in the labral injury. Conclusions. Evaluating the labrum after injection may improve visualization of labral injuries, as a result of greater labral conspicuity.

Key Words: hip • intra-articular injections • labrum • sonography

Abbreviations: MR, magnetic resonance

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.