In our spine edition of what is the difference between a x ray and a MRI, we talked about what we can see, and how they are used for diagnosis. This time let’s talk about the hip!

First let’s remember the simple truth that an x-ray is the same as taking a step back and looking at hip through big picture vs an MRI is a zoomed in and very detailed view.

An x-ray of the hip is going to show us the shape of the head of the femur; It will show us if it is nice and round, and it will show the hyaline cartilage (the smooth outer later) and it’s integrity. The head of the femur is important, a squared head is a common reason for extreme pain, reduced range of motion and also a hip replacement.

An X ray will also show us the health and length of the neck of the femur (this information is great for perfecting and customizing a person’s squat. In it well also see the joint relationship of the two ilium’s at the pubic symphysis. Changes to this joint are commonly seen with pregnancy and delivery but are also notable with SI dysfunction.

Now for the MRI!

Since the hip is such a heavy and weight bearing joint in a MRI the first structures we’ll look at will be the ligaments. Ligaments are bone to bone attachments which are not meant to be flexible more than about 2%, seeing as they hold you upright to standing! In the hip you have one ligament that’s inside the capsule itself and three that are extracapsular. In those deeper layers we’ll also see the health of the labrum. Tears to the labrum can happen in several different directions, typically indicated by the movement which causes pain, for which the MRI will verify via its imaging. Injuries to a labrum can happen for years before ever being discovered! As we move outwards well to see the soft tissue aka muscles and the tendons of those muscles which support the joint. Commonly (common but not normal, just normal for the pain which caused the need for the MRI) well see minor tears or fraying of muscles that are overused as well as any edema to the area. With this, an MRI of the hip may also offer information on tendonitis of some or multiple muscles as well as confirm bursitis.

Did you know you can decrease pain and increase range of motion with stability exercises? You can schedule this with us virtually or in person to review imaging with you and explain in simple terms what you need to know and what questions you need to ask when seeing your provider.