Radiographic Evaluation of the Painful Adolescent and Young Adult Hip

Radiographic evaluation of hip pain in adolescents and young adults is an important component of the assessment to aid in the identification of the cause of pain, distinguish between etiologies of early hip degeneration such as acetabular dysplasia (instability) and femoroacetabular impingement (FAI), and guide further workup and management. Recent advances in radiographic assessment include: the importance of obtaining a standing anterior-posterior (AP) radiograph to illustrate the functional position of the pelvis, the use of anterior and posterior wall indices to illustrate anterior and posterior wall coverage, and the importance of interpreting radiographic measures in the context of a patient’s sagittal balance. Advances in MRI, CT, and ultrasound have also occurred and can provide further diagnostic clarity. The purpose of this work is to review the literature to provide a systematic approach to the radiographic evaluation of hip pain in skeletally mature adolescents and young adults.