Magnetic Resonance Imaging Parameters in the Evaluation of Non-traumatic Painful Hip Joint

Background: Non-traumatic hip pain encompasses a wide range of musculoskeletal pathologies, with MRI serving as a valuable diagnostic tool due to its detailed visualization of bone and soft tissue structures. This study aimed to evaluate the MRI findings in patients presenting with non-traumatic hip pain at a tertiary care center in Nepal. Methods: A prospective observational study was conducted at NAMS, Bir Hospital from September 2024 to September 2025. One hundred patients with acute or chronic non-traumatic hip pain underwent MRI evaluation using a 1.5 Tesla scanner. Patients with traumatic hip pain or prior hip surgery were excluded. MRI parameters including joint space narrowing, subchondral edema, osteophytes, bone destruction, and soft tissue changes were analyzed. Results: The study included 55 males and 45 females, with a mean age of 60 years (range 20–70). Osteoarthritis was the most common diagnosis (50%), characterized by marginal osteophytes, joint space narrowing, subchondral sclerosis, and labral tears. Avascular necrosis accounted for 10% of cases, showing femoral head destruction and flattening. Infectious pathologies including tubercular and septic arthritis were found in 8% of patients each, with distinct MRI features such as joint effusion, bony erosion, and soft tissue inflammation. Less common diagnoses included transient synovitis (8%), transient osteoporosis (5%), femoral osteomyelitis (5%), Perthes disease (2%), slipped capital femoral epiphysis (2%), and osteosarcoma (2%). Conclusion: MRI is an essential imaging modality for diagnosing diverse causes of non-traumatic hip pain, facilitating early detection and management. Osteoarthritis remains the predominant pathology, but MRI also effectively identifies infective, inflammatory, and rare malignant conditions, underscoring its critical role in patient care.