Anterior Hip

[Katrina Jensen]

Hi Stephen.
We are hoping you might be able to help us out with ant hip assessment. When we see thickening along the femoral neck, do you describe this as a hip joint effusion, thickening of the iliofemoral ligament or synovial thickening? Do you have a measurement you use when deciding if this is thickened? Is normal less than 7mm? Do you routinely compare to the other side? I have attached an image of a recent patient who was asymptomatic. Does this change how you describe the findings?

Thanks
Katrina

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[Brian Richards]

You are measuring the inferior recess of the hip joint. If there is no fluid in it and it’s anterior surface is convex then i would call it synovial hypertrophy. Compare to other side. This is usually associated with some sort of joint pathology.

[Stephen Bird]

Yes, I agree. This is the iliofemoral ligament and there is significant synovial proliferation here. I would call this synovitis and it is usually associated with some degenerative joint condition like OA or possibly inflammatory condition like RA. Either way I think it is an abnormal appearance even if the patient is relatively asymptomatic at the time. I do not have a measurement , however once the joint capsule becomes convex relative to the femoral neck it is thick.
Steve

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