Clinical diagnosis of femoroacetabular impingement.

The diagnosis of femoroacetabular impingement (FAI) syndrome is made based on a combination of clinical symptoms, physical examination findings, and imaging studies. A detailed assessment of each of these components is important to differentiate FAI from other intra- and extra-articular hip disorders. Clinical and physical examination findings must be viewed collectively because no single pathognomonic finding exists for FAI. Nevertheless, common components of the history and physical examination do suggest a diagnosis of FAI

Diagnostic imaging of femoroacetabular impingement.

Imaging studies play a key role in establishing the diagnosis of femoroacetabular impingement (FAI). When clinical examination is suggestive of FAI, radiographic evidence should confirm the diagnosis. Imaging findings must be evaluated in the context of the patient's clinical presentation and recreational activities. Plain radiographic evaluation remains the initial diagnostic modality. Three-dimensional imaging such as MRI and CT often is obtained for the evaluation of labral and cartilage pathology, definition of bony anatomy, and surgical planning

Hip Joint Restoration

In the UK, a Non-Arthroplasty Hip Register (NAHR) was launched in 2012 to allow data collection for patients with hip conditions other than arthroplasty or fracture (e.g. iliopsoas impingement, SUFE, Perthes, etc.). The NAHR can track the outcome of conservative or surgical treatment. The surgeon can choose to enter as many scores and procedures as he/she wishes over any time interval. The NAHR plots the results over time and displays them graphically. For patients with FAI, pre-operative scores (including EQ5-D and iHOT-12) are collected automatically by the Registry. Only one pathway can be opened for each hip for an individual. If a surgeon tries to register a patient where a pathway has already been started, he/she will be prompted to contact the previous surgeon through the Registry and allowed to add to the data pathway for that patient. By collecting longitudinal outcomes in this way, it will be possible to answer key questions concerning the natural history of, and the effect of surgical treatment on, hip pathologies

Radiographic findings of femoroacetabular impingement in capoeira players

Purpose. Capoeira is a Brazilian martial art that requires extreme movements of the hip to perform jumps and kicks. This study evaluated a group of capoeira players to assess the prevalence of femoroacetabular impingement (FAI) in athletes practicing this martial art. Methods. Twenty-four experienced capoeira players (14 men, 10 women) underwent a diagnostic assessment, including clinical examination and standard radiographs of the pelvis and hips. The a-angle, head–neck offset, crossover sign, acetabular index, lateral centre-edge angle, and the Tonnis grade were assessed using the radiographs. Clinical relationships for any radiographic abnormalities indicating FAI were also evaluated. Results. Four subjects (17 %) reported pain in their hips. Forty-four hips (91.7 %) had at least one radiographic sign of CAM impingement, and 22 (45.8 %) had an a-angle of more than 60_. Eighteen hips (37.5 %) had at least one sign of pincer impingement and 16 (33.3 %) a positive crossover sign. Sixteen hips (33.3 %) had mixed impingement. There was a significant positive association between having an a-angle of more than 60_ and the presence of groin pain (P = 0.002). A reduced femoral head–neck offset (P<0.001) and an increased a-angle on the anteroposterior radiograph (P = 0.008) were independently associated with a higher Tonnis grade. Conclusion. High prevalence of radiographic CAM-type FAI among these skilled capoeira players was found. In these subjects, a negative clinical correlation for an increased a-angle was also detected. Additional caution should be exercised whenever subjects with past or present hip pain engage in capoeira