Hip and Pelvic Problems in Athletes

In the athletic population, the differential diagnosis of hip pain is quite broad and must include intra-articular pathology, extra-articular pathology, and central pubic pain associated with athletic pubalgia. In addition to an appropriately performed history and physical examination, advanced imaging techniques, including magnetic resonance imaging (MRI) and ultrasound, often are required to narrow the differential diagnosis. MRI is an excellent modality to image the pelvis and hip because of its ability to screen the pelvis for other etiologies of pain, its superior soft-tissue contrast, which allows visualization of the articular cartilage, fibrocartilaginous labrum, and myotendinous junctions, and its lack of ionizing radiation. During the last decade, the management of hip injuries has evolved substantially as a result of the advancement in techniques and flexible instrumentation for hip arthroscopy. Currently, a variety of hip pathologies may be addressed arthroscopically, including labral tears, loose bodies, femoroacetabular impingement, coxa saltans, ligamentum teres injuries, and capsular laxity. This article will focus on common etiologies of hip and pelvis pain in the athletic population with an emphasis on the use of hip arthroscopy to treat these disorders.