Strategy and optimization of diagnostic imaging in painful hip in adults.
Fiche publication
Date publication
février 2015
Journal
Orthopaedics & traumatology, surgery & research : OTSR
Auteurs
Membres identifiés du Cancéropôle Est :
Pr TEIXEIRA GONDIM Pedro
Tous les auteurs :
Blum A, Raymond A, Teixeira P
Lien Pubmed
Résumé
Diagnostic imaging strategy in painful hip depends on many factors, but in all cases, plain X-ray is the first investigation. It may be sufficient to reach diagnosis and determine treatment options. More effective but more expensive exploration is indicated in two circumstances: when plain X-ray is non-contributive, and when diagnosis has been established but more accurate imaging assessment is needed to guide treatment. Following radiography, the choice of imaging techniques depends not only on the suspected pathology but also on the availability of equipment and its performance. MRI is probably the technique that provides the most comprehensive results; recent improved accessibility has significantly simplified the diagnostic algorithm. CT remains invaluable, and current techniques have reduced patient irradiation to a level similar to that of standard X-ray. Finally, cost is an important consideration in choosing the means of exploration, but the overall financial impact of the various strategies for diagnosis of painful hip is not well established. This article aims to provide a simple and effective diagnostic strategy for the assessment of painful hip, taking account of the clinical situation, and to detail the most typical semiologic patterns of each disease affecting this joint.
Mots clés
CT scan, Cost-effectiveness, Diagnostic strategy, Hip, MRI, Osteoarthritis, Standard radiography, Tumor
Référence
Orthop Traumatol Surg Res. 2015 Feb;101(1 Suppl):S85-99