Hi, it's Dr. Centeno, and today I'd
like to bring you through how to read your hip MRI,
and we're going to focus on the top three things to know.
So this isn't meant as a substitute
for your radiology report, for your doctor's opinion.
It's just to educate you about your hip,
and what might be wrong.
An MRI is a 3D picture that slices
through the hip in three planes, Sagittal, Coronal, and Axial.
So kind of like slicing through a tomato, an onion,
you're slicing through the body.
And again there are these three different planes.
And those three different planes are, the Sagittal plane,
the Corona plane, and the Axial.
So the Coronal plane is kind of a front view,
the Sagittal view is a side view,
an Axial is sort of a saw-you-in-half view.
You want the Coronal image because it's
going to be the easiest one to look at,
and it may be labeled COR.
And if you look at how the hip is put together,
the hip is a ball and socket joint, so we have a ball,
we have a socket, and then there's
the lip around the socket called the labrum.
So those are some of the things that we'll be looking at.
So let's go over the top three areas to review.
Number 1 is, look at the cartilage area.
So you see here in this particular image
that you've got dark bone down here, and dark bone here,
and then you've got the ball in its socket.
And the gray stuff between my two red lines
here is the cartilage.
So you should have gray stuff in there.
And you might also see a picture where the bone is not quite as
dark or even the bone is bright, but the cartilage itself
is in here, and will look gray.
So that's the first area to look at,
if you don't have much cartilage,
and we'll look at that in an image here, in just a minute.
Then that's arthritis.
So this gives you some idea.
Here this particular patient has less cartilage in this area,
or less gray stuff in this area.
And this particular patient has no gray stuff, at all.
So that gives you an idea of this particular patient
over here has severe arthritis.
This patient over here, more moderate arthritis.
And again if we're to blow that up,
you can see here, as you take a look at it,
that in this particular area right here
there's less gray stuff, so less cartilage.
Now look at the labrum.
The labrum again, is the lip around the socket for the ball
and socket joint.
So the labrum is going to be an important thing to look at.
And I've shown you three different labrum.
Here are three different labral tears.
So you can see here we have the labrum which
is this structure right here.
And we have this white area, or light area in the labrum that
represents a tear.
Again, here we have the labrum.
Here, and this light area in there, that represents a tear.
Here we have the labrum in here, and this light area in there,
this white area that represents a tear.
So going backwards, you can see here
that this labrum doesn't have much white in it.
So that's more of a normal labrum,
and then you can see the labral tears here.
Look at the bone third.
So the bone is again, in this particular area here.
You want to make sure that it's uniform in color.
In this case, it's uniformly dark, so that's good.
In this case, the normal bone is white,
and you're seeing that here, but this dark area means dead bone.
So you're looking for a change in color.
And here we have a patient with large cysts.
I'm going to outline the cysts here, as on the ball side,
and some cysts on the socket side.
And that means, again, another type of dead bone.
If you've got problems in the bone,
it's an indicator of arthritis.
So now let's read some images here.
Off to the left, are images-- different kinds of images--
and we're going to bring over first this image, which
is a survey image, and this will show us both hips.
So we can get some sense of what both hips look
like as we scroll through.
And then we're going to go and look
for-- there is usually the one that is a close up of one hip.
Again, we can see in here, this is the labrum right here,
and we're looking for the cartilage in here,
and we're looking at the bone.
So if we look at this labrum, and there
is little light area in the labrum, as we scan through it,
right there.
And we're looking at the gray stuff in here,
or the cartilage.
And we're looking at the bone down here.
This patient has cartilage, maybe not
as much as the other side, or as much as they were born with,
so this would be mild arthritis.
The labor doesn't look that bad, and the bone
is nice and uniform.
Now we're going to go to a different patient
on the other end of this spectrum.
And we can see here that we do now have
changes in color in the bone.
These bright areas are areas where the bone is swelling
and starting to die off.
We've got no gray stuff, or very little gray stuff in here.
Meaning that they've lost most of their cartilage.
And we see a big bone spur, this big bulbous thing out here,
which is not a horrible thing.
A lot of surgeons love to take these bone spurs off,
but the recent research shows that they
are protective of the joint, and they're not hurting the joint.
They're actually protecting the joint.
So these shouldn't, generally, be removed, even though this
is a pretty large bulbous one.
But you get some idea of what this looks like.
Thanks for watching.
If you want more information on what
to do about these problems, and how
to treat hip arthritis without surgery, go to Regenexx.com.
Thanks.