Femoroacetabular impingement is a recent studied pathology,
which was first described in 2003.
It is a condition in which extra bone grows along one or both hip joint,
giving an irregular shape,
resulting overtime in pain and limiting the articular range of the joint,
it could lead to tears of the labrum and later,
breakdown of articular cartilage (osteoarthritis).
Some causes of femoroacetabular impingement can be related to sports activity when they repeat continuously internal hip rotation or vigorous hip overuse.
In most of the times the patient is young and very active,
and related to sports activity.
The first symptoms is pain in inguinal area,
sometimes related to a trauma episode,
and is fuelled by long time sitting or physical activity.
This is not an evident condition and sometimes,
symptoms are not clear,
because the patient may experience also lumbar pain,
knee pain,
sacroiliitis,
hip synovitis,
psoas tendonitis,
etc.
A proper physical examination followed by a radiologic examination is essential to diagnose correctly the patient condition.It is divided in three types: CAM,
PINCER and Mixed.
CAM - in this type,
the femoral head is not round and cannot rotate smoothly inside the acetabulum.
A bump forms on the edge of the femoral head that grinds the cartilage inside the acetabulum.
PINCER - this impingement occurs due to extra bone extends out over the normal rim of the acetabulum.
Therefore the labrum can be crushed/trapped under the prominent rim of the acetabulum.
Mixed - this is the result of both impingement (CAM and PINCER) manifestation in the same hip.
A well made radiograph is enough to diagnose this pathology,
and only in certain exceptional cases CT scan,
MRI and arthro MRI are needed for further characterization.
By choosing the right radiograph to get the accurate diagnosis,
time is saved,
less money is spent,
less radiation is applied to the patient and it’s faster.