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Imaging findings of femoroacetabular impingement syndrome

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Abstract

Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement—cam impingement and pincer impingement—are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients’ symptoms.

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References

  1. Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop 1999; 363:93–99.

    Article  PubMed  Google Scholar 

  2. Ito K, Minka MA II, Leunig M, Werlen S, Ganz R. Femoracetabular impingement and the cam-effect: an MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 2001; 83:171–176.

    Article  PubMed  Google Scholar 

  3. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 2002; 84:556–560.

    Article  PubMed  Google Scholar 

  4. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. J Bone Joint Surg Br 2003; 85:278–286.

    Google Scholar 

  5. Kim YT, Azuma H. The nerve endings of the acetabular rim. Clin Orthop 1995; 320:176–181.

    Google Scholar 

  6. Harris H. Harris Hip Score. J Bone Joint Surg Am 1969; 51:737–755.

    PubMed  Google Scholar 

  7. Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br 1991; 73:423–429.

    PubMed  Google Scholar 

  8. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular Impingement. Clin Orthop 2003;417:112–120.

    PubMed  Google Scholar 

  9. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br 1999; 81:281–288.

    Article  PubMed  Google Scholar 

  10. Tonnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 1999; 81:1747–1770.

    PubMed  Google Scholar 

  11. Goodman DA, Feighan JE, Smith AD, et. al. Subclinical slipped capital femoral epiphysis. J Bone Joint Surg Am 1997; 79:1489–1497.

    PubMed  Google Scholar 

  12. Leunig M, Beck M, Woo A, Dora C, Kerboull M, Ganz R. Acetabular rim degeneration: a constant finding in the aged hip. Clin Orthop 2003; 413:201–207.

    Google Scholar 

  13. Eijer H, Myers SR, Ganz R. Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma 2001; 15:475–481.

    Article  PubMed  Google Scholar 

  14. Daenen B, Preidler KW, Padmanabhan S, et al. Symptomatic herniation pits of the femoral neck: anatomic and clinical study. AJR Am J Roentgenol 1997; 168:149–153.

    PubMed  Google Scholar 

  15. Leunig M, Werlen S, Ungersbock A, Ito K, Ganz R. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Br 1997; 79:230–234.

    Article  PubMed  Google Scholar 

  16. Schmid MR, Notzli HP, Zanetti M, et al. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 2003; 226:382–386.

    Google Scholar 

  17. Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R, Siebenrock KA. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage 2003; 11:508–518.

    Article  PubMed  Google Scholar 

  18. Snow SW, Keret D, Scarangella S, Bowen JR. Anterior impingement of the femoral head: a late phenomenon of Legg-Calve-Perthes’ disease. J Pediatr Orthop 1993; 13:286–289.

    PubMed  Google Scholar 

  19. Harris WH, Bourne RB, Oh I. Intra-articular acetabular labrum: a possible etiological factor in certain cases of OA of the hip. J Bone Joint Surg Am 1979; 61:510–514.

    PubMed  Google Scholar 

  20. Stulberg SD, Cordell LD, Harris WH, Ramsey PL, McEwen GD. Unrecognized childhood hip disease: a major cause of idiopathic OA of the hip. In: Proceedings of the 3rd meeting of the Hip Society. St Louis: CV Mosby, 1975:212–228.

  21. Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement. I. Techniques of joint preserving surgery. Clin Orthop 2004; 418:61–66.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiologal Sciences, University of Oklahoma Health Sciences Center, 825 N.E. 10th Street, Suite 1400, Oklahoma City, OK 73104, USA

    Douglas P. Beall, Clifford F. Sweet, Hal D. Martin, Craig L. Lastine, David E. Grayson, Justin Q. Ly & Jon R. Fish

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  1. Douglas P. Beall
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  2. Clifford F. Sweet
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  3. Hal D. Martin
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  4. Craig L. Lastine
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  6. Justin Q. Ly
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  7. Jon R. Fish
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Corresponding author

Correspondence to Jon R. Fish.

Appendix. Definitions

Appendix. Definitions

1:

Femoral head-neck offset: The offset refers to the difference between the maximal anterior radius of the femoral head and the anterior radius of the adjacent femoral neck. This is also called the head to neck ratio.

2:

Cam impingement: Impingement characterized by a nonspherical femoral head and an abnormal prominence of the head-neck junction. The prominence produces a cam effect as the prominence of the femoral head impinges against the associated region of the acetabulum when the femoral head rotates into the hip joint.

3:

Pincer impingement: Abnormal contact between the femoral neck and the acetabular rim with no abnormal sphericity of the femoral head. This type of impingement is most often seen in patients that have abnormal anatomy (i.e., acetabular retroversion, coxa magna or coxa vara).

4:

Alpha angle: Analogous to the lateral radiographic view of the femoral neck, this angle is obtained by measuring the angle from the center of the femoral head (at the level of the center of the femoral neck) to the point where the osseous femoral head-neck junction meets the extrapolated circular diameter of the femoral head. This angle is measured on an oblique axial plane that is parallel to the femoral neck.

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Beall, D.P., Sweet, C.F., Martin, H.D. et al. Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 34, 691–701 (2005). https://doi.org/10.1007/s00256-005-0932-9

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  • DOI: https://doi.org/10.1007/s00256-005-0932-9

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