Still no answers...

My MRA report reads "The anterosuperior acetabular labrum is somewhat diminutive but there is no definite discrete labral tear..."

Two radiologists as well as my sports doctor have looked at the scan and all concur that there is not much to see. I guess that is a good thing but then where is the pain coming from?! The doctor wants to wait for me to see the hip surgeon on the 26th of Feb to confirm this before he decides what to to do next. Should the hip guy find no intra-articular cause for the pain, the doc will give me a cortisone injection into the hip joint as he thinks the problem may be an inflammation of the synovium which could not be resolved with ordinary anti-inflammatories. I am skeptical though that inflammation would hang around for this long....?

The scan did show a low grade tear in the insertional fibres of the gluteus medius but the doctor does not think this is the cause of the pain. I guess patience is in order once again....so countdown to the 26th begins!

My MRA report....
(it does not say much but may be of use to someone?...)


MRI ARTHROGRAM RIGHT HIP


Indication:
6 months history of anterior hip pain with positive quadrant test.
Negative x-ray and scintigram. ? hip labral pathology.

Findings:
Informed consent. Routine Dotarem and Lignocaine right hip
arthrogram.

Anterior impingement test positive, including downward/posterior
pressure and some external rotation.
Some improvement but not complete abolition of discomfort post
arthrogram.

Acetabular anteversion appears normal on the right side measured at
approximately 18degrees.
Femoral head-neck off-set also appears normal.

The anterosuperior acetabular labrum is somewhat diminutive but there
is no definite discrete labral tear nor intrasubstance signal
abnormality within the labrum.

Acetabular and femoral head chondral surfaces remain normally
preserved.
No underlying marrow oedema. Normal ligamentum teres.

There is subtle signal abnormality just anterior to the insertional
fibres of the gluteus medius tendon which could represent low grade
tendinosis. The gluteus medius tendon otherwise is satisfactory.
Normal gluteus minimus tendon. No trochanteric bursal effusion.

Symphysis pubis and proximal left adductors appear normal.
Symmetric normal hamstrings origins.
No definite regional muscle signal abnormality elsewhere around the
right hip.

CONCLUSION:
1. No definite intra-articular cause evident to account for right hip
pain.
2. Equivocal/subtle increased signal just anterior to gluteus medius
insertional fibres could represent low grade gluteus medius
insertional tear.

Big Tuesday...the day of the MRA

The MRA is now done and dusted. Report will be ready by tomorrow so by the time I meet with my sports doctor in the afternoon he should have an idea what we are dealing with (hopefully!).

The procedure itself was completely painless much to my surprise. I read some horrible MRA experiences on a couple of the forums so I came in prepared for the worst. P was in the room with me (wearing a metal waist coat and wrap around skirt....quite amusing actually!) holding my hand which helped calm the nerves. The radiologist was really thorough in explaining everything (and v. patient considering I had a thousand and one questions that I had generated form my vast reading on the subject!). In the end I didn't even feel the needle go in or the solution being injected. There was a slight funny feeling when he pulled it out but that's it. Afterwards the joint felt a little different although, if I didn't know I had fluid in it, I probably wouldn't have noticed. As for the anaesthetic taking the pain away - I really cannot be sure. During the MRI scan the pain was actually worse (although that may have been because they internally rotated my legs). Afterwards, when the radiologist preformed the impingement test the pain was less sharp but still there. I guess I will have to wait for the results tomorrow. Aaaaah...the waiting game!

I miss home!

P and I went to watch "Invictus" last night and it has made us both so homesick! Although a sugar-coated version of the events, it really brought out the true flavour of South Africa. Felt like bursting out in song when Nkosi Sikelele resounded in the cinema. There is just something about Africa that cannot be found elsewhere...

Edward Hopper - Summer Evening