I have had left hip pain for two years and am under medication and physical therapy. Could you please review my MRI reports?

Q. What does my MRI report suggest regarding my left hip pain?

Answered by
Dr. Vivek Chail
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 26, 2022 and last reviewed on: Jun 29, 2023

Hello doctor,

I have had left hip pain for two years. I had hip pain following a bicycle ride and was admitted to the hospital for severe lower back pain on the left side. At that time, I was treated with muscle relaxants, painkillers, and physical therapy. I have on and off left hip pain for the last two years. I am not able to do running, cycling, long-distance walking, prolonged sitting or standing, and specific activities provoke pain. I am continuing physical therapy and medications. I am attaching my recent magnetic resonance imaging (MRI) reports. Kindly provide your opinion on the MRI images of the left hip. Thank you.



Welcome to icliniq.com. I read your query and understand your concern. I have reviewed the attached images (attachments removed to protect the patient's identity). Here is a review of the left hip's magnetic resonance imaging (MRI). 1. Articular cartilage is preserved in both articulating surfaces. No significant joint effusion. No intra-articular loose body. 2. Head and neck of the femur appear normal. 3. The acetabulum appears normal. 4. Sacro-iliac joints included in the study region appear normal. The only finding which might contribute to left hip pain is a suspicious inflammation of the gluteal tendon attachment in the lateral part. However, I am not completely convinced that only this might be causing your symptoms. Please share the further details provided by your radiologist. Thank you.

Hello doctor,

Thank you for your response. The radiology opinion for the MRI is shared below: 1. Indication - left hip pain; the strain of left piriformis. 2. Technique - Magnetic resonance imaging (MRI) of the left hip is performed utilizing coronal STIR and T1 axial sequence as well as fast spin echo, coronal, sagittal, and axial oblique sequence. 3. Comparison - No prior studies were available for comparison at the time of dictation. 4. Findings - Pubic symphysis is intact. No tear of the synchondrosis or adductor plate and no fracture of the bony pelvis. 5. No hip fracture - No avascular necrosis. The contour of the femoral head-neck junction is preserved on non-oblique axial imaging, and no capsular tear. 6. Mild hip joint narrowing, trace joint effusion, and anterior superior labral tear. 7. Gluteal tendons are intact, and no bursitis. 8. Fat planes around the sciatic nerve are intact. Hamstrings are intact. No muscle atrophy or tear and no narrowing of the ischiofemoral interval. 9. No enlarged lymphadenopathy and no free fluid in the pelvis. 10. Impression: Anterior superior labral tear and mild hip joint narrowing with trace joint effusion. Thank you.



Welcome back to icliniq.com. I read your query and understand your concern. My comments are: 1. The anterior superior labral tear is a condition that is best visualized in arthrography or when there is significant effusion. Though there is a small altered signal area in the anterior labrum, it is difficult to confirm this finding with accuracy in routine magnetic resonance imaging (MRI) due to technical reasons. In this context, I prefer not to stress much about the finding in the given images. 2. The fluid in the joint is mentioned as a trace, and such amounts of fluid are usually not of significance and are visualized in many normal subjects. 3. The decreased left hip joint space is something I do not completely agree with. This is a subjective view; honestly, I do not find many variations in the left hip joint space compared to the right hip. As there is mention of piriformis strain in the clinical history, I suggest you discuss with your doctor regarding a lumbar spine MRI to search for any other causes of your problems. For example, you may have conditions in the spine causing hip pain even if there is no lower back pain. I hope I was helpful to you. Thank you.

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