Hip IMAGING ANATOMY Overview • Ball and socket joint with wide range of motion 2nd only to glenohumeral joint Acetabulum • Formed by pubis, ilium, ischium • Oriented anterior, inferior, lateral • Covers > 50% of femoral head • Anterior and posterior rims : Osseous margins of acetabulum • Medial wall : Quadrilateral plate ilium Femoral Head • 2/3 of sphere • Covered by articular cartilage Cartilage thickest superiorly Cartilage thins at head/neck junction Labrum • Fibrocartilage lip deepens acetabular rim • Joins transverse ligament at margins of acetabular notch • Thickest posteriorly and superiorly • Widest anteriorly and superiorly • Vascular supply: Branches of obturator, superior, and inferior gluteal arteries Mainly capsular surface • Shape Triangular in 66-94% Variants: Rounded/blunt or absent Absent labra: Constellation absent anterior labrum and small remnant superiorly – In 10-14% of asymptomatic individuals • Function Protect cartilage: Distributes forces by maintaining synovial fluid layer between articular surfaces Prevents lateral translation femoral head • Labral tear Frequently has associated paralabral ganglion/cyst Easier to detect in presence of joint effusion/arthrographic contrast More common anterosuperiorly and anteriorly Joint Capsule • 2 layers: Internal synovial and external fibrous (not usually separable on imaging) External layer forms capsular ligaments • Attachments Acetabulum – Base of labrum anteriorly and posteriorly – Several millimeters above labrum superiorly Femur – Anterior: Intertrochanteric line – Posterior: Proximal to intertrochanteric crest – Anterior attachment more lateral than posterior attachment Perilabral recess : Between labrum and capsule – Smaller anteriorly and posteriorly – Larger superiorly Vascular Supply • Branches of medial and lateral circumflex femoral, deep division of superior gluteal, inferior gluteal arteries, artery of ligamentum teres (branch of obturator artery) Innervation • Branches from nerve to rectus femoris, nerve to quadratus femoris, anterior division of obturator nerve, accessory obturator nerve, superior gluteal nerve Major Adjacent Structures • Greater trochanter Insertion – Gluteus minimus and medius muscles – Gluteus minimus to anterior facet – Gluteus medius to lateral and posterosuperior facets Separated from overlying iliotibial tract by thin trochanteric bursa (normally barely perceptible on imaging) Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Hand Vessels Elbow Soft Tissue Tumor Biopsy Hypoechoic Muscle Mass Hip and Pelvis Procedures Baker Cyst Stay updated, free articles. Join our Telegram channel Join Tags: Diagnostic Ultrasound Musculoskeletal Apr 9, 2020 | Posted by admin in MUSCULOSKELETAL IMAGING | Comments Off on Hip Full access? Get Clinical Tree
Hip IMAGING ANATOMY Overview • Ball and socket joint with wide range of motion 2nd only to glenohumeral joint Acetabulum • Formed by pubis, ilium, ischium • Oriented anterior, inferior, lateral • Covers > 50% of femoral head • Anterior and posterior rims : Osseous margins of acetabulum • Medial wall : Quadrilateral plate ilium Femoral Head • 2/3 of sphere • Covered by articular cartilage Cartilage thickest superiorly Cartilage thins at head/neck junction Labrum • Fibrocartilage lip deepens acetabular rim • Joins transverse ligament at margins of acetabular notch • Thickest posteriorly and superiorly • Widest anteriorly and superiorly • Vascular supply: Branches of obturator, superior, and inferior gluteal arteries Mainly capsular surface • Shape Triangular in 66-94% Variants: Rounded/blunt or absent Absent labra: Constellation absent anterior labrum and small remnant superiorly – In 10-14% of asymptomatic individuals • Function Protect cartilage: Distributes forces by maintaining synovial fluid layer between articular surfaces Prevents lateral translation femoral head • Labral tear Frequently has associated paralabral ganglion/cyst Easier to detect in presence of joint effusion/arthrographic contrast More common anterosuperiorly and anteriorly Joint Capsule • 2 layers: Internal synovial and external fibrous (not usually separable on imaging) External layer forms capsular ligaments • Attachments Acetabulum – Base of labrum anteriorly and posteriorly – Several millimeters above labrum superiorly Femur – Anterior: Intertrochanteric line – Posterior: Proximal to intertrochanteric crest – Anterior attachment more lateral than posterior attachment Perilabral recess : Between labrum and capsule – Smaller anteriorly and posteriorly – Larger superiorly Vascular Supply • Branches of medial and lateral circumflex femoral, deep division of superior gluteal, inferior gluteal arteries, artery of ligamentum teres (branch of obturator artery) Innervation • Branches from nerve to rectus femoris, nerve to quadratus femoris, anterior division of obturator nerve, accessory obturator nerve, superior gluteal nerve Major Adjacent Structures • Greater trochanter Insertion – Gluteus minimus and medius muscles – Gluteus minimus to anterior facet – Gluteus medius to lateral and posterosuperior facets Separated from overlying iliotibial tract by thin trochanteric bursa (normally barely perceptible on imaging) Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Hand Vessels Elbow Soft Tissue Tumor Biopsy Hypoechoic Muscle Mass Hip and Pelvis Procedures Baker Cyst Stay updated, free articles. Join our Telegram channel Join Tags: Diagnostic Ultrasound Musculoskeletal Apr 9, 2020 | Posted by admin in MUSCULOSKELETAL IMAGING | Comments Off on Hip Full access? Get Clinical Tree
