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Skeletal Radiology
Published in: Skeletal Radiology 6/2023

07-12-2022 | Hip Dysplasia | Scientific Article

The posterior crescent sign on MRI and MR arthrography: is it a marker of hip dysplasia and instability?

Authors: Andrew A. MacDonald, Donna G. Blankenbaker, Matthew J. Brick, Chris M. Hanna, Rebecca M. Woodward

Published in: Skeletal Radiology | Issue 6/2023

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Abstract

Objective

To evaluate the prevalence of the ‘posterior crescent sign’ in symptomatic patients referred for MRI/MR arthrogram of the hip and identify any correlation with imaging features of joint pathology.

Materials and methods

Retrospective imaging assessment of a cohort of 1462 hips, from 1380 included MR examinations (82 bilateral) retrieved from a search of all examinations in patients 16–50 years old from June 2018 to June 2021, with median age 45.8 years (range 17.8–50.0) and 936 hips (64%) in women. Radiographic and MR findings related to hip dysplasia, femoroacetabular impingement and osteoarthritis were assessed.

Results

Fifty-one hips (3.5%) were positive for the posterior crescent sign, median age of 45.8 years (range 17.8–50.0) and 29 (58%) in women. Radiographic findings included the following: mean lateral centre edge angle (LCEA) 22.2° (± 7.8°) with LCEA < 20° in 15 (31%) and LCEA 20–25° in 17 (35%) and mean acetabular index (AI) of 13.1° (± 5.8°) with AI > 13° in 22 (45%). MR findings included the following: mean anterior acetabular sector angle (AASA) 54.3° (± 9.8°), mean posterior acetabular sector angle (PASA) 92.7° (± 7.0°), labral tear at 3–4 o’clock in 20 (39%), high-grade acetabular chondral loss in 42 (83%) and ligamentum teres abnormality in 20 (39%).

Conclusion

The posterior crescent sign occurs in 3.5% of symptomatic young and middle-aged adults on MR. It is associated with overt and borderline hip dysplasia and other findings of hip instability. It is also associated with osteoarthritis in some cases and should be interpreted with caution in these patients.
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Metadata
Title
The posterior crescent sign on MRI and MR arthrography: is it a marker of hip dysplasia and instability?
Authors
Andrew A. MacDonald
Donna G. Blankenbaker
Matthew J. Brick
Chris M. Hanna
Rebecca M. Woodward
Publication date
07-12-2022
Publisher
Springer Berlin Heidelberg
Keyword
Hip Dysplasia
Published in
Skeletal Radiology / Issue 6/2023
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04248-6

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