Purpose
To analyse literature-described MRI findings seen in patients presenting with new onset or persistent pain following hip arthroscopy for femoroacetabular impingement (FAI).
Methods and Materials
Post arthroscopy pain syndrome - PAPS,
was observed in 86 out of 511 patients seen in our institution,
who underwent arthroscopy between January 2013 and December 2015.
We analysed the interval MRI studies performed for all 84 consecutive patients who presented with PAPS,
within 3 months of arthroscopy.
We compared the findings seen on MRI with the pre-operative MRI studies performed up to 6 months prior to arthroscopy.
In addition,
we correlate the MRI findings with other modalities performed within the same time period (Plain...
Results
Contralateral hip pain was observed in 86.9%,
with MRI depicted soft tissue or bony abnormalities detected in 73%.
MRI findings of PAPS in our cohort of patients includes:
MRI findings
Number of patients
Total =84 patients
Percentage
(%)
Obliteration of the superior paralabral sulcus
70
83.30
Synovitis (Total)
60
71.42
Synovitis requiring image-guided steroid injections
38
45.30
Transitional vertebra(e) at the lumbosacral junction
29
34.50
Sacroiliitis
26
31.00
Psoas tendonosis
24
28.60
Facet arthropathy at the lumbosacral junction
23
27.40
Persistent marrow oedema in the...
Conclusion
Most causes of PAPS identified in our study are transient,
with little/no underlying residual bony or soft tissue damage.
This correlates well with previous studies.
FAI is also related to other developmental abnormalities,
affecting other joints within the lumbosacral-pelvic unit.
The mechanical effect of these abnormalities remains poorly understood.
Future research is required (with some projects currently underway in our institution) to evaluate the pelvis as one unit formed of several components,
namely two SIJs,
two hip joints,
lumbosacral junction and symphysis pubis,
rather than...
References
Nepple JJ,
Lehmann CL,
Ross JR,
Schoenecker PL,
Clohisy JC.
Coxa profunda is not a useful radiographic parameter for diagnosing pincer-type emoroacetabular impingement.
J Bone Joint Surg Am.
2013; 95(5):417–423.
[PubMed: 23467864]
Dudda M,
Albers C,
Mamisch TC,
Werlen S,
Beck M.
Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res.
2009; 467(3):651–659.
[PubMed: 19023635]
Nouh MR,
Schweitzer ME,
Rybak L,
Cohen J.
Femoroacetabular impingement: can the alpha angle be estimated? AJR Am J Roentgenol.
2008; 190(5):1260–1262.
[PubMed: 18430841]
Rakhra...
Personal Information
Dr Danoob Dalili
Specialist Registrar Clinical Radiology,
Imperial College London,
UK
Research fellow,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Mohit Bansal
Specialist Registrar Orthopaedic Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Nasha Khandwalla
Physician Associate,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marc George
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Zameer Shah
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marcus...