Ultrasound of the hip

Abstract

The adult hip poses several challenges to ultrasound evaluation. The structures are deeply situated requiring the use of relatively low-frequency transducers (5-8 MHz range), thereby limiting resolution. Variable amounts of abdominal fat often cause aberration of the ultrasound beam. Doppler assessment is also limited due to diminished flow sensitivity in evaluating deep structures. Despite these limitations, ultrasound can display a variety of pathologic conditions about the hip. The realtime capability allows assessment of conditions elicited by provocative maneuvers (i.e., snapping hip syndromes). Ultrasound provides guidance for performance of selective interventional procedures, and it is not subject to artifact introduced by indwelling metallic hardware. Ultrasound is, therefore, playing an increasingly important diagnostic and therapeutic role in patients with hip pain. Following a brief overview of ultrasound technique and normal sonographic anatomy, a variety of common clinical applications of ultrasound of the hip are discussed.