Objective: Hip pain, which poses a diagnostic challenge, is common in children. In this study we aim to evaluate the diagnostic value of MRI in children with hip pain. Results are compared with radiographic findings. Imaging protocol suggestions are established.

Material and Methods: 52 children (24F/28 M; mean age: 9.4 years) who underwent an MR exam for hip pain were included. MR findings were retrospectively reavaluated and diagnosis were verified by using a combination of clinical and laboratory findings. Specificity, sensitivity and accuracy of MRI were calculated. Radiographic findings of the subgroup with X-rays were detected.

Results: MRI revealed normal findings in 18 and pathological findings in 34 patients. 6 cases were accepted as ‘false negative’ depending on clinical and laboratory findings. 7 sacroileitis were detected in patients with an age range of 7 to 17 years. The sensitivity, specificity and accuracy of MRI were calculated as 85%, 100% and 88% respectively. Contrast administration added diagnostic value in 8 of the 22 cases (36%) with enhanced imaging. In 35 patients who underwent X-ray examination, only 6 patients (17%) - all with bony lesions - had pathological findings.

Conclusion: MRI can be used as the first line imaging modality for hip pain in children in centers where it is easily accessable. X-rays shoud be limited to certain bony pathologies. IV contast administration adds value to MRI in selected cases. We suggest to add sacroiliac joint specific sequences to the MRI protocol for hip pain in children over 7 years.

Keywords: Pain, Child, Hip, MR