TEST ONLY DONT PUBLISH HIP ACETABULAR LABRUM MRI MORE THAN JUST TEARS: MUCOID DEGENERATION

MUCOID DEGENERATION

There is a lot written about acetabular labral tears but there are other abnormalities of the labrum that can be precursors to or associated with tears. Here we look at Mucoid Degeneration.

Mucoid degeneration of the acetabular labrum is not uncommon, but Ive not been able to find too much written about it apart from passing references to it in articles dealing with the labrum.

MRI MUCOID DEGENERATION: SOME BACKGROUND

The MRI findings are T2/PD hyper-intensity and enlargement of the labrum which can be focal or diffuse.
Intra labral cysts can also develop.
We see it more often in the anterosuperior and superolateral labrum
The MRI changes are similar to mucoid degeneration of other structures like the ACL or degeneration that can occur in a discoid meniscus.
Mucoid degeneration can occur in an otherwise normal labrum or in dysplastic labrums associated with acetabular dysplasia.

MRI MUCOID DEGENERATION: WHAT TO LOOK FOR

MUCOID DEGENERATION

Image Above: PD and PDFS scans. Enlargement and diffuse hyper-intensity superolateral labrum (yellow arrow). Signal intensity is high but not as high as fluid.

MUCOID DEGENERATION EARLY CYSTIC CHANGE

Image above: PDFS all same patient: Early cystic change (yellow arrow) within mucoid degeneration. More posterior image demonstrates mucoid degeneration (blue arrows) without cystic change where the signal is increased but not approximating fluid signal.

MUCOID DEGENERATION/INTRALABRAL CYST

Image above: PDFS: Areas of hyper-intensity (yellow arrow) approximating fluid signal suggesting early cyst formation.

MUCOID DEGENERATION & TEAR

Image above all from the same patient: First image (Red arrow) early changes of mucoid degeneration with slight increased signal. Second image (Yellow arrow) more pronounced changes. Third image (blue arrow) associated labral tear at margins of mucoid degeneration.

LOCALIZED MUCOID DEGENERATION

Image above: PD, Radial scan. Localized progressive increase in mucoid degeneration anterior labrum (yellow arrow) and a completely normal posterior labrum (blue arrow).

EXTENSIVE CYSTIC MUCOID DEGENERATION

Image Above: Generalized cystic mucoid degeneration (yellow arrows). Only the postero inferior labrum was spared (not shown). Green lines in 2nd image reflect the level of the first image axial scan. Blue arrow first image is a paralabral cyst from a labral tear.

We look at all of these topics in more detail in our HIP MRI Mini Fellowships.

Click on the image below for more information.

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