Editorial Commentary: Magnetic Resonance Imaging May Underestimate Hip Femoral Version Versus Computed Tomography Scan: Both May Be Optimized Using 3-Dimensional Imaging

Hip arthroscopy has become increasingly popular in the treatment of femoroacetabular impingement syndrome. Careful preoperative planning including evaluation of acetabular and femoral version is necessary to optimize outcomes. Increased femoral anteversion has been associated with microinstability, and conversely, decreased femoral version may predispose to impingement. Computed tomography (CT) is considered the gold standard for femoral version measurements and preoperative planning. However, with recent advancements in technology, magnetic resonance imaging (MRI) has shown comparable measurements to CT imaging. In terms of advantages and disadvantages, CT requires radiation, albeit "low dose." MRI has a longer acquisition time, and movement of the patient may affect image quality and subsequent accuracy. MRI generally underestimates true version, probably as a result of patient positioning. Three-dimensional imaging could resolve this issue and may become the gold standard for both CT and MRI.