Editorial Commentary: MRI May Underestimate Hip Femoral Version Versus CT Scan: Both May Be Optimized Using 3-Dimensional Imaging

Abstract

Hip arthroscopy has become increasingly popular in the treatment of femoroacetabular impingement syndrome (FAI). Careful preoperative planning including evaluation of acetabular and femoral version, is necessary to optimize outcomes. Increased femoral anteversion has been associated with microinstability, and conversely, decreased femoral version may predispose to impingement. Computed tomography (CT) is considered the “gold standard” for femoral version measurements and preoperative planning. However, recent advancements in magnetic resonance imaging (MRI) technologies have demonstrated comparable measurements to CT imaging. In terms of advantages and disadvantages, CT requires radiation, albeit “low dose.” MRI has longer acquisition time, and movement of the patient may impact image quality and subsequent accuracy. MRI generally underestimates true version, probably as a result of patient positioning. 3D imaging could resolve this issue and may become the gold-standard for both CT and MRI.