Wagner FV, Negrão JR, Campos J, Ward SR, Haghighi P, Trudell DJ, Resnick D.
PURPOSE: To demonstrate the anatomy of the capsular ligaments of the hip by using
magnetic resonance (MR) arthrography.
MATERIALS AND METHODS: Institutional policies were followed regarding cadaver
use. MR arthrographic images of 10 fresh human cadaveric hips were obtained by
using a positioning device to arrange the hip joint in different controlled
positions. MR appearances of the capsular structures were noted and correlated
with those seen on anatomic slices and dissections. Two readers working in
consensus graded the visibility of these structures. Tissue samples were
collected for histologic analysis. An MR positional study was performed to
evaluate the length of these capsular ligaments and the subjective classification
of their appearance as either taut or lax in extension, flexion, abduction,
adduction, and internal and external rotation.
RESULTS: The hip capsule inserts proximally and continuously to the acetabular
rim periosteum. Distally, it has a firm anterior insertion at the femoral
intertrochanteric line and no posterior osseous insertion. The inferior band of
the iliofemoral ligament was best evaluated in the sagittal, axial, and axial
oblique planes, and it serves a restrictive function in extension; the superior
band of the iliofemoral ligament was best evaluated in the coronal and axial
oblique planes, and it serves a restrictive function in external rotation; the
ischiofemoral ligament was best evaluated in the axial and axial oblique planes,
and it serves a restrictive role in internal rotation; the pubofemoral ligament
was best evaluated in the sagittal plane, and it serves a restrictive function in
abduction; and the zona orbicularis could be evaluated equally well in any
imaging plane.
CONCLUSION: MR arthrography enables visualization of the capsular ligaments of
the hip.
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