The relationship between chronic hip pain and femoroacetabular impingement: an evaluation with clinical signs and radiography
Namık Şahin1, Teoman Atıcı2, Alpaslan Öztürk1, Güven Özkaya3, Bülent Avcu1, Yüksel Özkan1
1Bursa Şevket Yılmaz Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, Bursa, Türkiye;
2Uludağ Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı
3Biyoistatistik Anabilim Dalı, Bursa, Türkiye;
Keywords: Acetabulum; arthralgia; femur; hip joint; radiography.
Objectives: In this study, we investigated the rate of the clinical and radiographic findings of femoroacetabular impingement (FAI) in patients with chronic hip pain and compared the findings with those of a control group.
Patients and methods: The clinical and radiographic findings of FAI in 38 patients (group 1) having hip pain for more than three months were analyzed and compared with 42 controls (group 2). Internal rotation degrees were measured while the hips were at 90° flexion and impingement test was performed by rotating the hips internally at 90° flexion and adduction. The FAI findings were investigated on anteroposterior pelvis radiographs and cross-table lateral radiographs of the hip joint in both groups. The collumdiaphyseal angle, alpha angle and anterior offset r atio o n t he femoral side and the center-edge angle, acetabular index, extrusion index and crossover sign on the acetabular side were evaluated.
Results: The internal rotation degree of the painful hips were less than 20º degree in 18 (47.4%) patients in group 1 and in one (2.4%) patient in group 2 (p<0.001). The impingement sign was positive in 15 (39.5%) patients in group 1 and in one (2.4%) patient in group 2 (p<0.001). While the rate of radiographic findings that can cause pincer type FAI were same in both groups, the rate of patients with radiographic findings that can cause cam type FAI was 76.3% (n=29) in group 1 and 42.9% (n=18) in group 2 (p=0.002).
Conclusion: Femoroacetabular impingement is one of the causes of chronic hip pain and if evaluated with suitable clinical and radiographic parameters, the rates of diagnosis may increase.