Medically reviewed by Prof. Dr. Aamer Nadeem Chaudhary, M.B.B.S., D.M.R.D., F.C.P.S. (Diagnostic Radiology), Consultant, Al-Nasar Lab & Diagnostic Centre. Updated October 2026.
Quick answer: A hip MRI shows bone marrow, cartilage, the labrum, tendons and the joint lining, none of which appear clearly on X-ray. It is the most sensitive test for early avascular necrosis, stress and hidden fractures, and labral tears. Most hip MRI scans need no injection, use no radiation, and take about 25 to 40 minutes.
Book a hip MRI: call 0300 0341944. MRI is performed at our main Johar Town campus.
Why X-ray is often not enough for hip pain
X-ray shows bone shape and established arthritis well. What it cannot show is what happens inside the bone and soft tissue before the shape changes.
In avascular necrosis, the bone is dying for months before it collapses. In a hidden fracture, the crack may be invisible on day one. In both, the X-ray can be completely normal at exactly the stage when treatment would help most.
MRI detects the swelling in bone marrow that comes first. That is why a painful hip with a normal X-ray is one of the clearest reasons for an MRI.
What hip MRI can detect
| Condition | Why it matters |
|---|---|
| Avascular necrosis (AVN) | Loss of blood supply to the ball of the hip. Early detection may allow joint saving treatment |
| Occult hip fracture | A fracture invisible on X-ray after a fall, especially in older adults |
| Stress fracture | Overuse fracture in runners, recruits and people with weak bone |
| Labral tear | Torn rim of cartilage around the socket, causing clicking, catching and groin pain |
| Cartilage damage and early arthritis | Thinning before it shows on X-ray |
| Tendon and bursa problems | Gluteal tendon tears and bursitis, a common cause of pain on the outer hip |
| Transient osteoporosis | Temporary painful marrow swelling, notably in late pregnancy |
| Infection and tumours | Uncommon but important to rule out with night pain or fever |
Avascular necrosis: who is at risk?
This deserves special attention in Pakistan.
- Steroid use is the leading preventable cause. This includes long courses, repeated injections and, very commonly here, steroids taken without prescription for joint pain, asthma or skin conditions, sometimes unknowingly in mixed “desi” remedies
- Heavy alcohol use
- Sickle cell disease and some other blood disorders
- Previous hip fracture or dislocation
- Radiotherapy, organ transplant, lupus and some cancer treatments
- A history of severe COVID treated with high dose steroids
AVN often affects both hips, even when only one hurts, which is why MRI usually images both sides.
Early signs are deep groin or buttock pain, worse on standing and walking, sometimes a limp. Anyone with these symptoms and a steroid history should not accept a normal X-ray as the final answer.
When should you have a hip MRI?
- Hip or groin pain lasting more than a few weeks with a normal X-ray
- Unable to bear weight after a fall, especially over age 60, even if the X-ray is normal
- A history of steroid use with new hip pain
- Clicking, locking or catching in the hip
- Pain on the outer hip that disturbs sleep
- Before hip surgery, for planning
- Night pain, fever or unexplained weight loss with hip pain
Low back problems can refer pain to the hip. If the picture is unclear your doctor may also order an MRI of the spine.
Do you need contrast?
Usually not. AVN, fractures, tendon problems and arthritis are all assessed without an injection.
For suspected labral tears, an MR arthrogram may be advised, where dilute contrast is injected into the joint before the scan to outline the tear. Contrast into a vein is used only for suspected infection or tumour. Our contrast guide explains more.
What happens during the scan
You lie on your back and go into the scanner feet first. For a hip scan your head is usually near the opening, though not always fully outside. A coil is placed over the pelvis.
The scanner is loud and ear protection is provided. Keeping still for each sequence of a few minutes is important. Feet are sometimes taped gently together, turned slightly inward, to position the hips correctly.
How to prepare
- No fasting is needed for a routine hip MRI
- Tell the team about any implant: pacemaker, defibrillator, cochlear implant, neurostimulator, aneurysm clip, or metal in the eye
- A hip replacement is usually not a barrier, though metal distorts nearby images. Bring your implant details
- Tell the doctor about steroid use, including injections and remedies whose contents you are unsure of
- Wear clothing without metal, or change into a gown
- Bring X-rays and previous reports
Hip MRI at Al-Nasar Lab
Al-Nasar Lab & Diagnostic Centre has served Lahore since 1996 and holds ISO 15189:2022 accreditation from the Pakistan National Accreditation Council. MRI, X-ray and DEXA bone density are all available at our Johar Town campus, reported by consultant radiologists, so a hip assessment can usually be completed in one visit.
Related reading: X-ray for fractures and knee MRI. See our accreditations, find your nearest location, or contact us to book.
Frequently Asked Questions
Can MRI detect avascular necrosis early?
Yes. MRI is the most sensitive test for early AVN and often shows it months before any change on X-ray.
My hip X-ray is normal but I still have pain. Should I have an MRI?
If pain persists for several weeks, or you cannot bear weight after a fall, MRI is often the right next step. Discuss it with your doctor.
Does a hip MRI need an injection?
Usually not. An MR arthrogram, with contrast injected into the joint, is sometimes used for suspected labral tears.
Can I have an MRI with a hip replacement?
Usually yes. Modern implants are generally MRI safe, though metal distorts images close to it.
Can steroids damage the hip?
Yes. Steroid use is a leading cause of avascular necrosis. Tell your doctor about any steroid use, including injections and unlabelled remedies.
Related reading: our guide to ankle MRI.
This article is for general information and is not a substitute for medical advice. Please discuss your results with a qualified doctor.
