Hip Imaging

Question 1

1. The standard first radiographic view for hip evaluation is:

A. Frog lateral only
B. Dunn view
C. AP view of hip and pelvis
D. Axial MRI

Answer 1

Answer: C
The AP view of the hip and pelvis is the standard first radiographic evaluation.

Question 2

2. The frog lateral view best visualizes:

A. Acetabular roof only
B. Femoral head-neck junction
C. Sacrum
D. Lumbar spine

Answer 2

Answer: B
The frog lateral view highlights the femoral head-neck junction.

Question 3

3. On an AP pelvis radiograph, the obturator foramen should appear:

A. Asymmetric
B. Equal bilaterally
C. Absent
D. Blurred

Answer 3

Answer: B
Symmetry indicates proper positioning.

Question 4

4. Radiographs are most useful for evaluating:

A. Labral tears
B. Articular cartilage only
C. Bony anatomy and alignment
D. Muscle atrophy

Answer 4

Answer: C
Radiographs primarily assess bony structures.

Question 5

5. The acetabulum articulates with the:

A. Greater trochanter
B. Femoral neck
C. Femoral head
D. Lesser trochanter

Answer 5

Answer: C
The femoral head articulates with the acetabulum.

Question 6

6. In sagittal T1 MRI, the acetabular labrum appears as:

A. Bright structure
B. Dark triangular structure
C. Fluid signal
D. Invisible

Answer 6

Answer: B
The labrum appears dark on T1-weighted imaging.

Question 7

7. T1-weighted MRI images are particularly useful for:

A. Fluid detection
B. Bone marrow and anatomy detail
C. Ligament tears only
D. Cartilage edema only

Answer 7

Answer: B
T1-weighted images highlight anatomical detail and marrow.

Question 8

8. The coronal MRI view best shows:

A. Axial rotation
B. Bilateral hip comparison
C. Sagittal structures only
D. Lumbar discs

Answer 8

Answer: B
Coronal view allows comparison of both hips.

Question 9

9. Axial MRI view is best for assessing:

A. Transverse plane structures
B. Sagittal alignment
C. Lumbar lordosis
D. Knee alignment

Answer 9

Answer: A
Axial view assesses transverse plane anatomy.

Question 10

10. Bone marrow edema on MRI suggests:

A. Normal finding
B. Stress reaction or fracture
C. Muscle strain
D. OA only

Answer 10

Answer: B
Bone marrow edema may indicate stress injury.

Question 11

11. For acute hip pain after fall with suspected fracture, initial imaging per ACR:

A. MRI first
B. CT first
C. Radiographs (AP pelvis/hip)
D. Ultrasound

Answer 11

Answer: C
Radiographs are usually appropriate first imaging.

Question 12

12. If radiographs are negative but fracture is still suspected, next imaging:

A. Repeat X-ray
B. MRI without IV contrast
C. Ultrasound
D. Bone scan first

Answer 12

Answer: B
MRI without IV contrast is usually appropriate next.

Question 13

13. For chronic hip pain, first imaging modality:

A. MRI with contrast
B. X-ray pelvis and hip
C. CT scan
D. PET scan

Answer 13

Answer: B
Radiographs are first-line for chronic hip pain.

Question 14

14. MRI without IV contrast is appropriate for chronic pain when:

A. Fracture is obvious
B. Radiographs are negative but soft tissue pathology suspected
C. Acute trauma only
D. Always first-line

Answer 14

Answer: B
MRI is appropriate when soft tissue pathology suspected.

Question 15

15. CT with IV contrast is generally:

A. Usually appropriate first-line
B. Usually not appropriate in many hip scenarios
C. Required for all fractures
D. First imaging for chronic pain

Answer 15

Answer: B
CT with IV contrast is often rated usually not appropriate.

Question 16

16. A 23-year-old female runner with groin pain and normal radiographs was later diagnosed with:

A. Labral tear
B. Femoral neck stress fracture
C. OA
D. Hip dysplasia

Answer 16

Answer: B
MRI revealed a nondisplaced femoral neck stress fracture.

Question 17

17. MRI findings in femoral neck stress fracture include:

A. Labral detachment
B. Bone marrow edema and signal change
C. Joint effusion only
D. Cartilage thinning only

Answer 17

Answer: B
MRI showed bone marrow edema and decreased signal intensity.

Question 18

18. A 53-year-old male with medial knee pain reproduced with hip flexion, IR, and adduction suggests:

A. Primary knee pathology
B. Hip pathology referring to knee
C. Ankle instability
D. Lumbar radiculopathy

Answer 18

Answer: B
Hip pathology can refer pain to medial knee.

Question 19

19. MRI findings in this medial knee pain case showed:

A. ACL tear
B. Acetabular dysplasia changes
C. Tibial plateau fracture
D. Patellar subluxation

Answer 19

Answer: B
Imaging demonstrated hip dysplasia findings.

Question 20

20. The 11-year-old gymnast with persistent hip pain required:

A. Repeat radiographs only
B. MR arthrogram (MRA)
C. CT scan
D. Bone scan only

Answer 20

Answer: B
MR arthrogram was ordered after persistent symptoms.

Question 21

21. MR arthrogram is especially useful for detecting:

A. Bone tumors
B. Labral tears
C. Muscle strains
D. Osteophytes only

Answer 21

Answer: B
MRA improves detection of labral pathology.

Question 22

22. Normal radiographs but persistent symptoms indicate:

A. No pathology
B. Advanced OA
C. Further imaging indicated
D. Immediate surgery

Answer 22

Answer: C
Persistent symptoms may require MRI or MRA.

Question 23

23. In acute hip pain, ultrasound is:

A. Usually appropriate first-line
B. Usually not appropriate for suspected fracture
C. Gold standard
D. Better than MRI

Answer 23

Answer: B
Ultrasound is usually not appropriate for suspected fracture.

Question 24

24. The AP pelvis radiograph in case 1 initially showed:

A. Clear fracture
B. No significant abnormality
C. Dysplasia
D. OA

Answer 24

Answer: B
Initial radiograph showed no significant abnormality.

Question 25

25. STIR MRI sequences are helpful because they: A. Highlight bone marrow edema B. Show cartilage only C. Replace radiographs D. Eliminate need for T1 images

Answer 25

Answer: A STIR sequences detect edema and stress reactions.

Question 26

26. Radiographic evaluation of hip dysplasia may include measurement of: A. Q angle B. LCEA C. Tibial slope D. Cobb angle

Answer 26

Answer: B LCEA is used to assess acetabular coverage.

Question 27

27. Joint space narrowing on radiographs suggests: A. Muscle tear B. Degenerative joint disease C. Stress fracture D. Labral tear only

Answer 27

Answer: B Joint space narrowing indicates degenerative changes.

Question 28

28. MRI is superior to radiographs for assessing: A. Cortical bone B. Soft tissue structures like labrum C. Alignment only D. Pelvic symmetry

Answer 28

Answer: B MRI evaluates soft tissue such as labrum and cartilage.

Question 29

29. Coronal MRI is especially useful for detecting: A. Sagittal plane motion B. Bilateral pathology comparison C. Knee pathology D. Ankle pathology

Answer 29

Answer: B Coronal view allows bilateral comparison.

Question 30

30. In suspected occult fracture, MRI is preferred because: A. It uses more radiation B. It detects bone marrow edema early C. It is cheaper D. It replaces X-rays entirely

Answer 30

Answer: B MRI detects early marrow changes not visible on X-ray.

Question 31

31. Imaging choice should follow: A. Patient preference only B. ACR appropriateness criteria C. Insurance request only D. Surgical availability

Answer 31

Answer: B Imaging decisions should follow ACR guidelines.

Question 32

32. CT without IV contrast may be considered when: A. MRI unavailable and fracture suspected B. First-line for chronic pain C. Evaluating labrum D. Always inappropriate

Answer 32

Answer: A CT may be appropriate if MRI unavailable for fracture evaluation.

Question 33

33. MRI without contrast is preferred over with contrast when: A. Evaluating soft tissue without need for arthrogram B. Always contraindicated C. Evaluating bone only D. Never appropriate

Answer 33

Answer: A Non-contrast MRI sufficient for many soft tissue cases.

Question 34

34. The frog lateral radiograph position places the hip in: A. Neutral B. Extension C. Flexion and abduction D. IR only

Answer 34

Answer: C Frog lateral positions hip in flexion and abduction.

Question 35

35. Key clinical takeaway regarding hip imaging: A. Radiographs detect all hip pathology B. MRI is unnecessary if X-ray negative C. Imaging modality depends on presentation and ACR guidelines D. CT with contrast is first-line for all cases

Answer 35

Answer: C Appropriate imaging depends on clinical presentation and ACR criteria.