Abstracts

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E2248. Young Adult Hip Pre-Operative CT: What the Orthopedic Surgeon Wants to Know
Authors
  1. Abraham Lajara; Mayo Clinic Florida
  2. Jeffrey Peterson; Mayo Clinic Florida
  3. Joseph Bestic; Mayo Clinic Florida
  4. Hillary Garner; Mayo Clinic Florida
  5. Daniel Wessell; Mayo Clinic Florida
  6. Luke Spencer-Gardner; Mayo Clinic Florida
  7. Rupert Stanborough; Mayo Clinic Florida
Background
Treatment of hip pain in young adults is a rapidly evolving field with developing surgical treatment options. Developmental aberrations in hip morphology have been linked as a cause of hip pain with implications for early osteoarthritis. When identified before the development of these early degenerative findings, hip preservation surgery can reduce pain and hopefully delay early osteoarthritis. These congenital and acquired hip conditions are diagnosed most often with physical exam and radiographs. Orthopedic surgeons are routinely requesting CT evaluation of the pelvis preceding surgery for a more detailed and quantitative evaluation of hip morphology. Low dose CT technique can be performed to reduce patient radiation exposure without limiting the ability to obtain accurate measurements. It is important to minimize radiation dose given the young age of these patients. In the educational exhibit, we will review the CT technique and rationale used at our institution and then review the findings relevant to the pre-operative evaluation of femoroacetabular impingement (FAI), hip dysplasia, and other related conditions.

Educational Goals / Teaching Points
1. Review the CT technique we use to reduce radiation dose including energy parameters and field of view. 2. Review useful post-processing reconstructions. 3. Review how to measure acetabular inclination, femoral torsion (or version), alpha angle, and other useful quantitative values. 4. Show examples of commonly encountered pathology in the young adult with hip pain.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. Acetabular retroversion and overcoverage has been linked with pincer-type FAI. 2. Deficient femoral head-neck junction offset has been linked with cam-type FAI. 3. Acetabular dysplasia has been linked with hip pain and early degeneration. 4. Multiple quantitative values have been shown to diagnose and estimate severity of dysplastic hips. 5. Morphology of the anterior inferior iliac spine (AIIS) and subspine region have been linked with impingement.

Conclusion
Pre-operative CT of the pelvis provides valuable qualitative and quantitative information to the orthopedic surgeon prior to hip preservation surgery in young adults with hip pain. Optimizing CT technique can ensure a low radiation dose to these young adult patients.