Hip MRI Report Template: Normal Example and Reporting Checklist

Normal hip MRI report: complete unilateral example

This framework is for a routine noncontrast MRI focused on one hip. Confirm whether the acquisition is a small-field hip study, a broader pelvis examination, or direct MR arthrography. State what was actually covered: a focused unilateral study does not constitute a dedicated assessment of the opposite hip or the entire pelvis.

Examination: MRI of the right hip without intravenous or intra-articular contrast.

Clinical indication: [Indication.]

Comparison: [Prior study and date / None available.]

Technique: Multiplanar, multisequence MRI of the right hip was performed without intravenous or intra-articular contrast.

Findings: Femoral head contour and marrow signal are within expected limits. No acute fracture, osteonecrosis, or focal marrow lesion is identified. The hip joint is congruent, with preserved articular cartilage and no significant effusion. No discrete acetabular labral tear is identified on this routine examination. The visualized ligamentum teres is intact. The iliopsoas, gluteus medius and minimus, and proximal hamstring tendons are intact. No significant peritrochanteric bursal fluid or muscle edema is present. The included pelvic soft tissues show no significant abnormality.

Impression: No significant abnormality identified on routine MRI of the right hip.

Modify the structures listed to match the protocol and coverage. Do not use a unilateral normal template to imply that both hips, all pelvic organs, or the whole pelvis were assessed.

Before interpretation

• Verify side, clinical question, prior radiographs or MRI, and any history of trauma, stress injury, surgery, or arthroplasty.
• Confirm the field of view and whether the study is a dedicated unilateral hip MRI, a bilateral survey, a pelvis MRI, or an arthrogram.
• Check image quality and whether the femoral head, acetabular roof, proximal femur, and relevant periarticular tendon insertions are included.
• Review marrow on fluid-sensitive and T1-weighted images, and look for susceptibility or motion that limits the labrum, cartilage, or bone.
• For postoperative studies, identify the procedure and available comparison images. Hardware and altered anatomy may affect the visible structures.

Systematic review checklist

Bone and marrow

Review the femoral head, neck, intertrochanteric region, acetabulum, and other included bones. Assess contour, marrow signal, fracture or stress response, osteonecrosis, and focal lesions. A routine hip MRI may not be the best examination for every question about cortical detail or complex bone morphology; state the scope and consider the available complementary imaging in context.

Joint, cartilage, and labrum

Assess joint congruity, effusion, visible cartilage, subchondral bone, and the acetabular labrum. If a labral abnormality is seen, describe location and morphology using the local convention, and report associated cartilage change, paralabral cyst, or displaced tissue. A clock-face location is meaningful only when the orientation convention is stated or understood locally. Labral and cartilage findings can also occur in people without symptoms, so do not assign symptom causation from the image alone.

Ligamentum teres and capsule

Review the ligamentum teres and capsule when they are adequately shown and relevant to the indication. Avoid a categorical negative if the acquisition or spatial resolution does not support confident evaluation.

Periarticular tendons, muscles, and bursae

Review the iliopsoas tendon, gluteus medius and minimus insertions, proximal hamstring origins when included, adductor structures if covered, and visible muscles. Describe tendinosis, partial or complete tearing, retraction, and adjacent edema where present. Note bursal fluid only when it is more than a trace or is otherwise relevant. Do not treat mild tendon signal as a diagnosis of a clinical pain syndrome by itself.

Included pelvis and opposite hip

Mention important incidental findings only within the imaged field. If the opposite hip or pelvic structures are partly seen, describe only what is adequately included; do not call them fully assessed.

Selected abnormal wording

Labrum: Linear signal extending to the articular surface at the [location] acetabular labrum, compatible with a tear in the context of this examination. [No displaced fragment or paralabral cyst is identified.]

Gluteal tendon: Mild insertional tendinosis of the [gluteus medius / gluteus minimus] tendon with a small [partial-thickness / full-thickness] defect at the [facet / footprint]. [No tendon retraction.]

Peritrochanteric soft tissues: Mild peritrochanteric edema with [trace / small] bursal fluid. These imaging findings are described without assigning a clinical pain syndrome.

Bone: Focal subchondral marrow edema-like signal at the [site], without a visible fracture line or articular surface collapse.

For an in-depth discussion of labral morphology, variants, and capsulolabral findings, see MRI of Hip Labral and Capsulolabral Lesions.

Fictional worked example: gluteus medius insertion

This teaching case is fictional. It illustrates a focused unilateral examination and avoids assuming that one imaging finding explains all symptoms.

Examination: MRI of the left hip without intravenous or intra-articular contrast.

Clinical indication: Lateral left hip pain.

Comparison: Left hip radiographs dated [date].

Technique: Multiplanar, multisequence MRI of the left hip was performed without intravenous or intra-articular contrast.

Findings: The femoral head contour and marrow signal are preserved. No fracture or osteonecrosis is identified. Hip joint cartilage is maintained, without significant effusion. No discrete labral tear is identified on this routine examination. There is mild insertional tendinosis of the gluteus medius with a small low-grade partial-thickness defect at the anterior facet. Mild adjacent peritrochanteric edema is present, without a sizable bursal collection or tendon retraction. The gluteus minimus and iliopsoas tendons are intact. No focal muscle edema is identified.

Impression:
1. Mild gluteus medius insertional tendinosis with a small low-grade partial-thickness defect and adjacent peritrochanteric edema.
2. No acute osseous abnormality.

The report identifies the abnormal tendon and its location, then records the important negative bone findings. Whether the finding accounts for the patient's symptoms requires clinical correlation.

Protocol limits and common pitfalls

A routine unilateral hip examination, bilateral survey, pelvis MRI, and direct MR arthrogram have different fields of view and sensitivity for individual structures. State the side, contrast route, and actual coverage in the technique. In a focused study, do not imply assessment of the whole pelvis; in a pelvis study, do not imply that both hips received dedicated small-field imaging.

Direct MR arthrography includes an intra-articular injection and is distinct from intravenous contrast administration. It may be selected for specific intra-articular questions, but should not be presumed from the words “hip MRI.” Conventional MRI can show labral pathology, but subtle findings may be protocol-dependent.

Avoid these shortcuts:

• Calling a labral tear the cause of pain. Studies have documented labral and cartilage abnormalities in asymptomatic volunteers.
• Reporting “normal labrum” when it is not confidently assessed on the acquired protocol.
• Treating a clock-face location as self-explanatory without an orientation convention.
• Describing partial views of the opposite hip or pelvis as a complete negative assessment.
• Using “bursitis” or a named pain syndrome for nonspecific trace fluid or mild edema alone.
• Applying a routine native-hip template to a postoperative hip without identifying altered anatomy and artifact.
• Calling marrow edema a fracture without a fracture line or other persuasive evidence.

Primary references

• American College of Radiology, Society for Pediatric Radiology, Society of Skeletal Radiology. Practice Parameter for the Performance and Interpretation of MRI of the Hip and Pelvis for Musculoskeletal Disorders. Official practice parameter (opens in a new tab)
• European Society of Skeletal Radiology. Guidelines for MR Imaging of Sports Injuries: MRI of the Hip. Official ESSR protocol (opens in a new tab)
• Tresch F, Dietrich TJ, Pfirrmann CWA, Sutter R. Hip MRI: Prevalence of articular cartilage defects and labral tears in asymptomatic volunteers. A comparison with a matched population of patients with femoroacetabular impingement. Journal of Magnetic Resonance Imaging. 2017;46(2):440–451. doi:10.1002/jmri.25565 (opens in a new tab)
• Schmitz MR, Campbell SE, Fajardo RS, Kadrmas WR. Identification of acetabular labral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. American Journal of Sports Medicine. 2012;40(6):1337–1341. doi:10.1177/0363546512439991 (opens in a new tab)

This educational framework does not replace patient-specific interpretation, current local protocols, or clinical judgment.