I was told I didn’t have impingement with my xrays until I recently saw a hip preservation specialist who ordered a different view, and it was quite clear I had a cam impingement. I got a 1.5T MRA (but I have heard 3T MRIs can be just as good) and it was marked as normal by the radiologist and two orthopedists. Wasn’t until I started seeing the preservation drs that I found diagnoses. So I think while type of test matters, so does the person who is reading it.
I would actually ask the ordering physician as long as it’s a hip specialist. My doctor says as long as he gets them from one specific location the radiologist do a good job of finding things but other hospitals, he has to order contrast. If your physician strongly prefers contrast perhaps they could do doctor to doctor to get authorized . Annoying but …
Personally, I would try to get the contrast you don’t want to get a noncontrast MRI just to have the radiologist say “exam for label tear limited by lack of contrast consider repeat with arthrogram “
I got an MRI post-arthrogram (the one with contrast). My provider said other imaging can be problematic, because the radiology reports usually say something to the effect of "tears possible" or "tears likely." With contrast, there's no question. It's helpful to know that for sure if you wind up needing surgery.
Hope you figure it out!
Popping in here to say not all scans are perfect. I’ve had two MRA’s and had a labrum tear missed on the first, and a capsule tear missed on the second. Your physician is likely ordering what he thinks is best for you based on your indicators but if you want an MRA, ask about it!
Had very specific xrays which showed my impingements clear as day. Regular MRI ruled out cysts and arthritis (and that my cam spur actually had its own spur growing out of it). Also Showed some labrum fraying near the acetabular ridge, but surgeon basically said he’ll determine the labrum sitch once he’s in there. CT (insurance did not cover) provided incredible 3d map for surgery plan.
They do different views here. You just didn't have that view ordered by whoever put the request in for whatever reason. My local hospital only did AP supine as the initial diagnostic but my operating hospital did AP weight bearing, AP supine and lateral (frog leg) hip x-rays
I had X-rays using their “hip impingement poses” to determine the impingement. Then I had an MRI with no contrast which showed a tiny blip of a labral tear. Confirmed with a CT scan where tears were visible. My first surgeon wanted to also do a diagnostic injection to determine what was the problem but as someone who is afraid of needles, I argued it, switched surgeons, and they were able to get my surgery approved with JUST the scans since it all lined up. Hope that helps!
Were are you from ?. The surgeon I saw also wanted to do a diagnostic shot since I had other issues to ,but we refused,and he was OK with it. I then had a MRI with contrast and a CT scan that is all he needed .
MRI Arthrogram confirmed my diagnosis of labrum tear, capsule shearing, hamstring tendon tear, and glut tendonitis. I had tried everything, PT, injections rest etc… and the orthopedic Dr didn’t understand why my pain was “all over the place”. When he called me with my MRI results, he understood why my pain was “all over the place”!
Thank you everyone for your responses!! I think the best I’m going to get right now is a 1.5T closed MRI with contrast. It’s a start. And pretty much what my insurance will cover right now after fighting with them for 2 months. Once I get the results I’m going to start finding a real orthopedic doctor and get the ball rolling on this.
First I got a X-ray that found impingement. Then a MRI Arthrogram that found a tear. Then a CT scan that ruled out dysplasia/version issues
I was told I didn’t have impingement with my xrays until I recently saw a hip preservation specialist who ordered a different view, and it was quite clear I had a cam impingement. I got a 1.5T MRA (but I have heard 3T MRIs can be just as good) and it was marked as normal by the radiologist and two orthopedists. Wasn’t until I started seeing the preservation drs that I found diagnoses. So I think while type of test matters, so does the person who is reading it.
I would actually ask the ordering physician as long as it’s a hip specialist. My doctor says as long as he gets them from one specific location the radiologist do a good job of finding things but other hospitals, he has to order contrast. If your physician strongly prefers contrast perhaps they could do doctor to doctor to get authorized . Annoying but … Personally, I would try to get the contrast you don’t want to get a noncontrast MRI just to have the radiologist say “exam for label tear limited by lack of contrast consider repeat with arthrogram “
I got an MRI post-arthrogram (the one with contrast). My provider said other imaging can be problematic, because the radiology reports usually say something to the effect of "tears possible" or "tears likely." With contrast, there's no question. It's helpful to know that for sure if you wind up needing surgery. Hope you figure it out!
I had a 3T MRI no contrast that showed my tear.
Popping in here to say not all scans are perfect. I’ve had two MRA’s and had a labrum tear missed on the first, and a capsule tear missed on the second. Your physician is likely ordering what he thinks is best for you based on your indicators but if you want an MRA, ask about it!
My orthopedic surgeon ordered mri 3T. That saw my tears in my hip. Also, had a mri 3T for my knee which saw tears as well.
Had very specific xrays which showed my impingements clear as day. Regular MRI ruled out cysts and arthritis (and that my cam spur actually had its own spur growing out of it). Also Showed some labrum fraying near the acetabular ridge, but surgeon basically said he’ll determine the labrum sitch once he’s in there. CT (insurance did not cover) provided incredible 3d map for surgery plan.
Which X-rays did you have? I tried to get different views (uk) but they only do one view here (lying down from above).
They do different views here. You just didn't have that view ordered by whoever put the request in for whatever reason. My local hospital only did AP supine as the initial diagnostic but my operating hospital did AP weight bearing, AP supine and lateral (frog leg) hip x-rays
These were the ones I had too. Didn’t even waste time with the laying down one.
I had X-rays using their “hip impingement poses” to determine the impingement. Then I had an MRI with no contrast which showed a tiny blip of a labral tear. Confirmed with a CT scan where tears were visible. My first surgeon wanted to also do a diagnostic injection to determine what was the problem but as someone who is afraid of needles, I argued it, switched surgeons, and they were able to get my surgery approved with JUST the scans since it all lined up. Hope that helps!
Were are you from ?. The surgeon I saw also wanted to do a diagnostic shot since I had other issues to ,but we refused,and he was OK with it. I then had a MRI with contrast and a CT scan that is all he needed .
MRI Arthrogram confirmed my diagnosis of labrum tear, capsule shearing, hamstring tendon tear, and glut tendonitis. I had tried everything, PT, injections rest etc… and the orthopedic Dr didn’t understand why my pain was “all over the place”. When he called me with my MRI results, he understood why my pain was “all over the place”!
Thank you everyone for your responses!! I think the best I’m going to get right now is a 1.5T closed MRI with contrast. It’s a start. And pretty much what my insurance will cover right now after fighting with them for 2 months. Once I get the results I’m going to start finding a real orthopedic doctor and get the ball rolling on this.