The hip joint is a complex structure in both form and function, which presents challenges for accurate diagnosis and treatment of pathology. Assessing acetabular version on plain radiographs can be particularly challenging as this requires extrapolation of 3-dimensional anatomy from 2-dimensional radiographic markers. The limitations inherent with plain radiographs of the hip have contributed to the increased use of advanced imaging including computed tomography scan and magnetic resonance imaging in the hip preservation world. Modern computed tomography scans provide incredibly detailed evaluation of the hip but do come with additional burden including cost and radiation exposure. In the era of "value-based healthcare," there is motivation to be cost-effective with resource utilization. Plain radiographs, when obtained with consistent and accurate technique, can adequately evaluate the complex structure of the acetabulum in a majority of patients and can identify those patients who would benefit from 3-dimensional imaging for complex deformities. By being thoughtful in our approach to evaluating these patients, we can be responsible stewards of our resources and advocates for our patients to avoid unnecessary testing.
Dustin Volkmer (Sun,) studied this question.