MR imaging evaluation of hamstring tendons reveals their association with subgluteal posterior hip pain, emphasizing the superiority of MR imaging over ultrasound due to the deep location of the hamstrings. This review encompasses various conditions, including overuse tendinopathy, metabolic disorders, and sports-related injuries prevalent in elite and recreational athletes. Practical MR imaging-guided approaches tailored to clinical needs and therapeutic options are discussed, highlighting MR imaging's crucial role in monitoring postinjury healing. Furthermore, potential residual complications are outlined, underscoring MR imaging's significance in diagnosing, treating, and evaluating hamstring tendon-related ailments comprehensively.

Entrapment neuropathies of the hip (ENH) can occur due to a variety of causes with clinical symptoms that may mimic musculoskeletal disorders. Etiologies include entrapment in a fibromuscular canal, tethering due to posttraumatic fibrosis and extrinsic compression from muscle hypertrophy or a mass. Magnetic resonance (MR) imaging enables detection and characterization of peripheral nerve pathology. In addition, MR imaging can impact both diagnostic judgment as well as therapeutic management (nonoperative and operative management) of patients with ENH. This review article will summarize the role of MR imaging in detection, characterization, and management of nerve entrapments around the hip joint.

Understanding the complex anatomy and development of the hip is crucial for diagnosing and categorizing femoral neck stress fractures in athletes. These fractures result from repetitive mechanical loading, affecting trabecular structure. Various risk factors include hormonal imbalances and hip geometry. Although radiographs are initial diagnostic tools, MR imaging is the gold standard, distinguishing between stress reactions and fractures. Treatment involves surgical fixation, whereas nonsurgical methods for less severe fractures have good results. Overall, comprehensive knowledge is essential for effective diagnosis and correct early management of femoral neck stress fractures.

MR imaging is a useful tool in establishing the diagnosis of inflammation and/or infection in the hip joint and adjacent tissues, and in determining the extent of disease. In conjunction with clinical factors, MR imaging findings can help to narrow the differential diagnosis in individual cases and can guide decisions regarding biopsies, aspirations, or additional imaging.

MR imaging of hip arthroplasty can be technically challenging due to artifacts associated with metallic implant components; however, utilization of specific parameter modifications and advanced metal reduction sequences allows acquisition of high-quality diagnostic images in patients with metallic implants. Given the increasing prevalence of hip arthroplasties within the population, familiarity with appropriate imaging techniques and expected pathology within this patient population is important knowledge for radiologists who encounter patients with hip arthroplasty in clinical practice.

Acetabular labral tears are a mechanical cause of hip pain. Hip MR imaging should be performed on 3T magnets using small field of view and high-resolution imaging. If using a lower strength magnet, direct arthrography should be performed. The following should be used in the assessment for labral tear abnormalities on MR (or MR arthrography): labral morphology, abnormal T2 signal (or contrast) extension into the labral substance or chondrolabral junction. Description of the labral tear and extent of tear is useful for the hip preservation surgeon. Understanding the pitfalls around the acetabular labral complex will help avoid misinterpretation of labral tears.

Hip dysplasia in the young adult population is a significant contributing factor in the development of early osteoarthritis. Diagnosis and treatment planning relies on a comprehensive imaging assessment of the hip joint morphology to better detect and characterize disease. This article discusses the various diagnostic markers of hip dysplasia in the adult population on radiography, computed tomography, and MR imaging.

Imaging plays a critical role in the preoperative and postoperative evaluation of patients with femoroacetabular impingement. Non-contrast MR imaging and direct magnetic resonance arthrography of the hip are the modalities of choice for the preoperative assessment of chondrolabral lesions. The MRI protocol should include radial images for detailed analysis of the cam deformity and fast sequences covering the pelvis and knee for measurement of femoral torsion. In patients with postoperative pain, a comprehensive analysis of residual deformities and signs of osseous overcorrection should be performed as they can cause residual impingement or iatrogenic instability.

Snapping hip is a common cause of hip complaints, so radiologists should have it on their radar when involved in the workup and care of young patients with hip complaints, especially those whose symptoms are localized to the greater trochanter or iliopsoas. Although history and physical examination often suggest the correct diagnosis, imaging evaluation, including ultrasonography and MR imaging, is valuable to identify responsible extra-articular structures, assess for the presence of any concurrent intra-articular pathology, identify underlying anatomic variants that might necessitate alterations in surgical technique, and guide steroid injections.

Ischiofemoral impingement syndrome (IFI) is a source of extra-articular pain caused by narrowing between ischium and femur in native hips. Secondary compression of quadratus femoris muscle leads to edema, tears, and deep gluteal pain. IFI is more frequent in females, with evidence pointing to a combination of hip, spine, and pelvic biomechanics and morphology leading to abnormal osseous relationships. This article provides updated concepts regarding the diagnosis, biomechanics, imaging, and treatment strategies for IFI. Moreover, IFI is emphasized as a multifactorial native hip syndrome, in contrast to ischiofemoral narrowing from secondary causes such as surgery, trauma, or masses.

Greater trochanteric syndrome (GTS) is a common condition clinically manifested by pain and tenderness over the greater trochanter. MR imaging plays a pivotal role in investigating the underlying cause of GTS. MR imaging can detect abnormalities not only in symptomatic but also in asymptomatic hips, thereby revealing structural damage in the gluteal tendons and muscles during both clinical and preclinical phases. This review article emphasizes the importance of detailed knowledge of anatomy of the greater trochanter and adjacent soft tissues, along with the imaging appearance of pathology of the abductor tendons and muscles as well as the peritrochanteric bursae.

Artificial intelligence (AI) can provide significant utility in the management of hip disorders by analyzing MR images. AI can automate image segmentation with success. Current models have been successfully tested in the diagnosis of osteoarthritis, femoroacetabular impingement, labral tears, developmental dysplasia of the hip, infection, osteonecrosis of the femoral head, and bone tumors. Many of these models have shown strong performances with accuracies in the range of 76% to 97%, and area under the curve of 77% to 98%. The recent trends indicate high interest and adoption of these tools in MR imaging assessment of hip disorders.

The proximal origin of the rectus femoris from the anterior superior iliac spine, anterior inferior iliac spine and the supraacetabular sulcus comprises the proximal tendinous complex. A practical MR imaging-guided approach adapted to the anatomy of the proximal tendinous complex and the myoconnective transitions along the rectus femoris is critical in accurately evaluating and following rectus femoris injuries. This review presents various conditions, including avulsions, tendon tears, and myoconnecive lesions along the muscle that can result in loss of function and pain. Furthermore, different pathologies or "abnormal states" that can present with symptoms similar to myoconnective lesions are demonstrated.

MR imaging protocols and technical parameters should be optimized in order to achieve the best diagnostic results. Routine hip MR imaging includes a combination of T1-weighted and fluid-sensitive sequences, obtained in coronal, axial, and sagittal planes. MR arthrography of the hip can be used for assessment of intra-articular pathology involving intricate and signal-poor structures such as articular cartilage, labral fibrocartilage, and intra-articular bodies. Emerging quantitative MR imaging techniques such as T1ρ, T2 mapping, and delayed gadolinium-enhanced MR imaging of cartilage allow for the assessment of biochemical changes associated with cartilage degeneration and osteoarthritis.

The hip joint is home to a diverse range of neoplasms, as well as many pseudo lesions, including post-traumatic, infectious, and degenerative processes. Through careful evaluation of the clinical context, location, and imaging features, these entities can be distinguished, enabling accurate and efficient diagnosis. While not exhaustive, this article reviews a selection of benign, malignant, and non-neoplastic lesions affecting the hip bones, cartilage, and soft tissues, focusing on their notable imaging and pathologic features.

Breakthroughs in medical imaging and ultrasound transducer design have led to feasible application of focused ultrasound (FUS) to intracranial pathologies. Currently, one of the most active fields in FUS has been the temporary disruption the blood-brain barrier. In addition to enhancing drug delivery to the brain, FUS blood-brain barrier disruption may allow liberation of biomarkers from the brain, thus facilitating ease of detection and adding the element of spatial specificity to an otherwise nonspecific test. This study reviews the current evidence to support FUS liquid biopsy and the challenges of advancing this field.

MR-guided focused ultrasound (MRgFUS) allows for the incisionless treatment of intracranial lesions in an outpatient setting. While this is currently approved for the surgical treatment of essential tremor and Parkinson's disease, advancements in imaging and ultrasound technology are allowing for the expansion of treatment indications to other intracranial diseases. In addition, these advancements are also making MRgFUS treatments easier, safer, and more efficacious.