However, the shape, contour, and spatial relationships of bones may not be demonstrated by radiography to the same degree as by cross-sectional modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Advantages of plain radiography include ease of access, rapid acquisition, lack of any post processing, and flexibility in patient positioning. Radiography is the first line of imaging for investigation of all hip pathologies, as it can demonstrate gross osseous alignment, morphology, and integrity. Knowledge of the strengths and limitations of the various available radiologic modalities can facilitate and expedite efficient diagnosis and management of hip pathology. It is important for the orthopedic surgeon, radiologist, rheumatologist, and physiatrist, and all other allied musculoskeletal specialists, to understand the basic principles of hip imaging. Today, several imaging modalities are available to physicians each modality has a multitude of variations and protocols that can be optimized according to the patient profile, the clinical scenario, and the nature of the hip pathology. In situations where the clinical history and physical examination findings are equivocal, orthopedic diagnosis and management of hip disorders often require adjuvant radiologic evidence of disease before treatment and intervention are begun. Radiologic investigation of the hip has rapidly evolved through advances in technology and in knowledge about the causes and physiology of hip disease. MRI is a robust imaging modality for detecting and characterizing a broad spectrum of hip pathologies, including ischemic, traumatic, inflammatory, arthritic, and neoplastic causes.

Radiography is the primary modality for characterizing and quantifying the degree of dysplasia and in evaluating for OA. Developmental dysplasia of the hip (DDH) is characterized by an underdeveloped acetabular fossa, which predisposes to hip instability and osteoarthritis (OA).Radiography and magnetic resonance imaging (MRI) can effectively demonstrate the primary anatomic deformities, as well as the secondary joint derangements that ensue with FAI. Femoroacetabular impingement (FAI) results from anatomic abnormalities of the acetabulum (pincer) and/or the femoral head-neck junction (cam).Radiography is the first line of imaging in investigating the hip various techniques and projections are used to optimize visualization of select structures and regions of the hip joint.A broad spectrum of radiologic investigations can be used to provide the orthopedic surgeon with important information regarding hip anatomy and pathology, hence facilitating diagnosis, monitoring, and treatment planning for hip disease.

Xray in normal hip