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Hip pain
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Treatments
Diagnosis & Evaluation
Hip Exam & Gait AnalysisHip X-ray & MRIDiagnostic Hip Injection
Non-Surgical Care
Hip Physical TherapyHip Pain MedicationHip Activity & Weight Plan
Injections & Orthobiologics
Cortisone Hip InjectionPRP Hip InjectionTrochanteric Bursa InjectionHip Nerve Ablation
Hip Arthroscopy & Preservation
Hip ArthroscopyHip Labral RepairFAI SurgeryGluteus Medius Tendon RepairPeriacetabular Osteotomy (PAO)
Hip Replacement
Total Hip ReplacementAnterior Hip ReplacementOutpatient Hip ReplacementHip ResurfacingRevision Hip Replacement
Fracture & Tendon Surgery
Hip Fracture SurgeryProximal Hamstring Repair
Compare
Anterior vs PosteriorArthroscopy vs ReplacementCortisone vs PRPSurgery vs Physical Therapy
Hip Health Library Saturday Hip Pain Clinic About Dr. Stride Location & hours Request an appointment
Diagnosis & Evaluation

The Right Hip Imaging, Read by a Hip Surgeon

Do you need an X-ray or an MRI for hip pain?

Hip X-rays and MRI answer different questions. Standing X-rays show arthritis, bone shape behind impingement and hip dysplasia, and are usually taken first. An MRI or MR arthrogram shows the labrum, cartilage, tendons and hidden stress fractures. Dr. Stride orders an MRI only when the result would change your treatment.

A good hip image starts with the right question. In most visits, standing X-rays taken in the office tell Dr. Stride a great deal about arthritis and bone shape within minutes. An MRI comes next only when soft tissue, such as the labrum or a gluteal tendon, holds the answer.

Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeon
Last reviewed October 2026
Dr. Stride walking a patient through a pelvis X-ray on the screen

At a glance

Also called
hip MRI arthrogram, MR arthrogram, pelvis X-ray, hip CT scan
After your visit
Ongoing
Ask about Hip X-ray & MRI →(713) 555-0168

Is this right for you?

Usually a good fit if

  • Groin pain with clicking or catching that suggests a labral tear
  • Active adults 35 to 50 with stiffness that may be early impingement or dysplasia
  • Adults 55+ deciding whether arthritis is advanced enough for a hip replacement
  • Runners with deep groin pain that could be a femoral neck stress fracture
  • People with an outside imaging report who want it read by a hip specialist

Another option may be better if

  • Ordering an MRI before any exam, since many labral findings on MRI cause no symptoms
  • MRI for people with certain pacemakers or metal fragments, unless cleared by the imaging center (a CT scan may be used instead)

What happens, step by step

  1. Standing X-rays in the office

    A front view of the pelvis taken while standing shows true joint space, since lying down can make arthritis look milder. Side views such as the Dunn or frog-leg view show the cam bump of femoroacetabular impingement (FAI), and a false-profile view shows how well the socket covers the ball.

  2. Measurements that guide treatment

    Dr. Stride measures angles such as the alpha angle for cam impingement and the lateral center-edge angle for dysplasia. These numbers help decide between arthroscopy, an osteotomy or a replacement.

  3. MRI or MR arthrogram

    A high-field MRI shows tendons, bone bruising, stress fractures and loss of blood supply to the femoral head (avascular necrosis). For a suspected labral tear, an MR arthrogram adds contrast dye injected into the joint first, which outlines the labrum and cartilage more clearly.

  4. CT or ultrasound when needed

    A low-dose CT scan with 3D images can map bone shape before impingement surgery or a revision. Ultrasound in the office checks tendons and bursae and guides injections.

What happens after the visit

Same visit

X-ray findings are reviewed with you on screen, side by side with what the exam showed.

1 to 3 days

If an MRI is needed, our team requests insurance approval and schedules it at a convenient imaging center.

After an MR arthrogram

The hip may feel full or achy for a day or two. Most people go back to normal activity the next day.

Results visit

Dr. Stride goes over the images with you, explains which findings matter and which are normal wear, and lays out options.

Ongoing

Follow-up X-rays are taken only when they would change a decision, such as tracking arthritis over time.

“I read every image myself, because the radiology report is written without ever seeing you walk. An MRI will almost always find something in an adult hip. My job is to tell you which finding is actually causing your pain.”

Dr. Stride, MD

Frequently asked questions

Will a hip X-ray show a labral tear?

No, X-rays do not show the labrum or other soft tissue. They do show the bone shapes that often cause labral tears, such as FAI and hip dysplasia. An MRI or MR arthrogram is used to see the labrum itself.

What is an MR arthrogram of the hip?

An MR arthrogram is an MRI taken after contrast dye is injected into the hip joint under X-ray or ultrasound guidance. The dye fills the joint and outlines the labrum and cartilage. A numbing medicine is often mixed in, which can also help show whether the joint is the pain source.

Can you bring an MRI from another doctor?

Yes, please bring the disc and the written report. Dr. Stride reviews the actual images, which often avoids repeating a scan. Recent X-rays are useful too, though standing X-rays are sometimes repeated to see the hip under body weight.

Why does insurance want an X-ray before an MRI?

Most insurance plans require X-rays and a trial of conservative care before approving an MRI for hip pain. X-rays also answer many questions by themselves, especially about arthritis. Our team handles the paperwork when an MRI is needed sooner.

Related treatments

Diagnosis

Hip Exam & Gait Analysis

A hip exam with an orthopedic hip specialist is a hands-on check of range of motion, labral and impingement signs, tendon strength and walking pattern.

Read more →Diagnosis

Diagnostic Hip Injection

A diagnostic hip injection places a numbing medicine directly into the hip joint under ultrasound or X-ray guidance.

Read more →Preservation

FAI Surgery

FAI surgery is an arthroscopic procedure that reshapes extra bone on the ball (cam) or rim of the socket (pincer) so the hip stops pinching when it bends and rotates.

Read more →Replacement

Total Hip Replacement

Total hip replacement replaces the worn ball and socket of an arthritic hip with a metal, ceramic and medical-grade plastic implant.

Read more →Compare

Arthroscopy vs Replacement

Hip arthroscopy and hip replacement treat different problems.

See the comparison →

Hip pain this can help with

Hip pain · Front of hip

Pain in the Front of the Hip and Groin

Front of hip and groin pain usually comes from inside the hip joint itself.

Causes & treatment →Hip pain · symptom

Is It Your Hip or Your Back?

Hip joint pain is usually felt in the groin or front of the thigh and flares with putting on socks or getting out of a car.

Causes & treatment →Hip pain · symptom

Hip Clicking, Popping and Snapping

Hip clicking or snapping, called snapping hip syndrome or coxa saltans, usually comes from a tendon sliding over bone.

Causes & treatment →Hip pain · symptom

Pain After Hip Replacement

Pain after hip replacement is normal for the first several weeks and usually fades steadily over about 3 months.

Causes & treatment →
From the Hip Health Library

Questions patients ask about this

All guides →
Couple in their sixties walking on a park path
Pain & Warning Signs

Groin Pain When Walking: Is It Your Hip?

Groin pain when walking very often comes from the hip joint itself.

6 min read Read
Man climbing outdoor steps with a hand on his sore hip
Tears & Injuries

Hip Pain After a Fall but No Bruise: Could It Still Be Broken?

Yes, a hip can be broken even without a bruise.

5 min read Read
Dr. Stride walking a patient through a pelvis X-ray on the screen
Treatment & Recovery

Hip Pain but the X-Ray Shows Nothing: What Next?

A normal hip X-ray means your bones look intact, but it does not rule out a problem.

5 min read Read
SourcesReferences used for this page3

Medically reviewed by Dr. Stride, MD against current guidance from these sources. Last reviewed October 2026. How we write and review content

  1. X-rays, CT Scans, and MRI Scans (opens in a new tab) AAOS OrthoInfo
  2. Joint x-ray (opens in a new tab) MedlinePlus
  3. Femoroacetabular Impingement (opens in a new tab) AAOS OrthoInfo
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