Hip pain - metal deletion technique

Inner thigh pain (fictitious history)

This patient has a left hip arthroplasty. Note the associated hardware artifact which significantly limits evaluation of the adductor region .

A metal artifact reduction post processing algorithm was applied, resulting in significantly improved visualization of the adductor compartment, obturator canal, and surrounding soft tissues. The obturator canal in particular is easier to evaluate . In this patient w/ inner thigh pain, these post processed images can help you exclude avulsion of the adductor muscles, mass lesions, and fluid collections.

The left obturator internus muscle, innervated by the nerve to obturator internis (L5, S1), is atrophic. This finding, along with mild atrophy of the longus/brevis muscles, could reflect obturator denervation or relate to the hip arthroplasty surgery (more common in posterior approach).

Pudendal nerve denervation can occur in Alcock's canal, located more inferiorly.

Accession: CL0519

Study description: CT ABDOMEN/PELVISW