Femoroacetabular Impingement Radiographic Diagnosis: A Current Concept Review
-
Mir Mansour Moazen Jamshidi
,
Alireza Moharrami
,
Amir Hossein Poopak
,
Amir Hossein Mafi
,
Amir Reza Mafi
Abstract
Femoroacetabular impingement (FAI) could cause early osteoarthritis in patients. It is important to diagnosis this condition in the early stages to avoid osteoarthritis. The radiological x-ray is one of the main methods to diagnose FAI. There are many radiological signs which help orthopedic surgeons to diagnose FAI in the pelvic x-ray. Recent studies revealed many new signs for diagnosis and in the present concept article, we try to review all the radiological signs of the FAI in the pelvic and hip x-ray.
1. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: A cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):112-20. doi: 10.1097/01.blo.0000096804.78689.c2. [PubMed: 14646708].
2. Philippon MJ, Yen YM, Briggs KK, Kuppersmith DA, Maxwell RB. Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: A preliminary report. J Pediatr Orthop. 2008;28(7):705-10. doi: 10.1097/BPO.0b013e318186eb2e. [PubMed: 18812894].
3. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: Femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012-8. doi: 10.1302/0301-620X.87B7.15203. [PubMed: 15972923].
4. Jager M, Wild A, Westhoff B, Krauspe R. Femoroacetabular impingement caused by a femoral osseous head-neck bump deformity: Clinical, radiological, and experimental results. J Orthop Sci. 2004;9(3):256-63. doi: 10.1007/s00776-004-0770-y. [PubMed: 15168180].
5. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: Radiographic diagnosis--what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540-52. doi: 10.2214/AJR.06.0921. [PubMed: 17515374].
6. Bittersohl B, Hosalkar HS, Hesper T, Tiderius CJ, Zilkens C, Krauspe R. Advanced imaging in femoroacetabular impingement: Current state and future prospects. Front Surg. 2015;2:34. doi: 10.3389/fsurg.2015.00034. [PubMed: 26258129]. [PubMed Central: PMC4513289].
7. Tonnis D. General radiography of the hip joint. In: Tonnis D, editor. Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Heidelberg: Springer Berlin Heidelberg; 1987. p. 100-42.
8. Tannast M, Siebenrock KA. Imaging: Plain radiographs. In: Sekiya JK, Safran MR, Ranawat AS, Leunig M, editors. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia, PA: W.B. Saunders; 2011. p. 23-34.
9. Tannast M, Fritsch S, Zheng G, Siebenrock KA, Steppacher SD. Which radiographic hip parameters do not have to be corrected for pelvic rotation and tilt? Clin Orthop Relat Res. 2015;473(4):1255-66. doi: 10.1007/s11999-014-3936-8. [PubMed: 25231153]. [PubMed Central: PMC4353539].
10. Tannast M, Mistry S, Steppacher SD, Reichenbach S, Langlotz F, Siebenrock KA, et al. Radiographic analysis of femoroacetabular impingement with Hip2Norm-reliable and validated. J Orthop Res. 2008;26(9):1199-205. doi: 10.1002/jor.20653. [PubMed: 18404737].
11. Tannast M, Zheng G, Anderegg C, Burckhardt K, Langlotz F, Ganz R, et al. Tilt and rotation correction of acetabular version on pelvic radiographs. Clin Orthop Relat Res. 2005;438:182-90. doi: 10.1097/01.blo.0000167669.26068.c5. [PubMed: 16131889].
12. 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(4):556-60. doi: 10.1302/0301-620x.84b4.12014. [PubMed: 12043778].
13. Toogood PA, Skalak A, Cooperman DR. Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res. 2009;467(4):876-85. doi: 10.1007/s11999-008-0473-3. [PubMed: 18758876]. [PubMed Central: PMC2650061].
14. Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):263-9. doi: 10.1097/01.blo.0000093014.90435.64. [PubMed: 14646725].
15. Ito K, Minka MA, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83(2):171-6. doi: 10.1302/0301-620x.83b2.11092. [PubMed: 11284559].
16. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: Part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;(418):67-73. Retrieved from. [PubMed: 15043095].
17. Stulberg SD. Unrecognized childhood hip disease: A major cause of idiopathic osteoarthritis of the hip. In: Cordell LD, Harris WH, Ramsey PL, MacEwen GD, editors. The hip: Proceedings of the 3rd Open Scientific Meeting of the Hip
Society. St Louis, MO: CV Mosby; 1975. p. 212-28.
18. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986;(213):20-33. Retrieved from. [PubMed: 3780093].
19. Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res. 2004;(418):54-60. doi: 10.1097/00003086-200401000-00010. [PubMed: 15043093].
20. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br. 1999;81(2):281-8. doi: 10.1302/0301-620x.81b2.8291. [PubMed: 10204935].
21. Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999;(363):93-9. Retrieved from. [PubMed: 10379309].
22. Sutton R, Azboy I, Restrepo C, Parvizi J. Ptosis of the hip: A new
radiographic finding in patients undergoing femoroacetabular osteoplasty. J Hip Preserv Surg. 2018;5(4):425-34. doi: 10.1093/jhps/hny039. [PubMed: 30647934]. [PubMed Central: PMC6328752].
23. Saito M, Tsukada S, Yoshida K, Okada Y, Tasaki A. Correlation of alpha angle between various radiographic projections and radial magnetic resonance imaging for cam deformity in femoral head-neck junction. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):77-83. doi: 10.1007/s00167-016-4046-9. [PubMed: 26878850].
24. Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77(7):985-9. doi: 10.2106/00004623-199507000-00002. [PubMed: 7608241].
25. Tonnis D, Heinecke A. Acetabular and femoral anteversion: Relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81(12):1747-70. doi: 10.2106/00004623-199912000-00014. [PubMed: 10608388].
26. Meyer DC, Beck M, Ellis T, Ganz R, Leunig M. Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006;445:181-5. doi: 10.1097/01.blo.0000201168.72388.24. [PubMed: 16456309].
27. Pitt MJ, Graham AR, Shipman JH, Birkby W. Herniation pit of the femoral neck. AJR Am J Roentgenol. 1982;138(6):1115-21. doi: 10.2214/ajr.138.6.1115. [PubMed: 6979213].
28. Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R. Fibrocystic changes at anterosuperior femoral neck: Prevalence in hips with femoroacetabular impingement. Radiology. 2005;236(1):237-46. doi: 10.1148/radiol.2361040140. [PubMed: 15987977].
2. Philippon MJ, Yen YM, Briggs KK, Kuppersmith DA, Maxwell RB. Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: A preliminary report. J Pediatr Orthop. 2008;28(7):705-10. doi: 10.1097/BPO.0b013e318186eb2e. [PubMed: 18812894].
3. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: Femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012-8. doi: 10.1302/0301-620X.87B7.15203. [PubMed: 15972923].
4. Jager M, Wild A, Westhoff B, Krauspe R. Femoroacetabular impingement caused by a femoral osseous head-neck bump deformity: Clinical, radiological, and experimental results. J Orthop Sci. 2004;9(3):256-63. doi: 10.1007/s00776-004-0770-y. [PubMed: 15168180].
5. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: Radiographic diagnosis--what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540-52. doi: 10.2214/AJR.06.0921. [PubMed: 17515374].
6. Bittersohl B, Hosalkar HS, Hesper T, Tiderius CJ, Zilkens C, Krauspe R. Advanced imaging in femoroacetabular impingement: Current state and future prospects. Front Surg. 2015;2:34. doi: 10.3389/fsurg.2015.00034. [PubMed: 26258129]. [PubMed Central: PMC4513289].
7. Tonnis D. General radiography of the hip joint. In: Tonnis D, editor. Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Heidelberg: Springer Berlin Heidelberg; 1987. p. 100-42.
8. Tannast M, Siebenrock KA. Imaging: Plain radiographs. In: Sekiya JK, Safran MR, Ranawat AS, Leunig M, editors. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia, PA: W.B. Saunders; 2011. p. 23-34.
9. Tannast M, Fritsch S, Zheng G, Siebenrock KA, Steppacher SD. Which radiographic hip parameters do not have to be corrected for pelvic rotation and tilt? Clin Orthop Relat Res. 2015;473(4):1255-66. doi: 10.1007/s11999-014-3936-8. [PubMed: 25231153]. [PubMed Central: PMC4353539].
10. Tannast M, Mistry S, Steppacher SD, Reichenbach S, Langlotz F, Siebenrock KA, et al. Radiographic analysis of femoroacetabular impingement with Hip2Norm-reliable and validated. J Orthop Res. 2008;26(9):1199-205. doi: 10.1002/jor.20653. [PubMed: 18404737].
11. Tannast M, Zheng G, Anderegg C, Burckhardt K, Langlotz F, Ganz R, et al. Tilt and rotation correction of acetabular version on pelvic radiographs. Clin Orthop Relat Res. 2005;438:182-90. doi: 10.1097/01.blo.0000167669.26068.c5. [PubMed: 16131889].
12. 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(4):556-60. doi: 10.1302/0301-620x.84b4.12014. [PubMed: 12043778].
13. Toogood PA, Skalak A, Cooperman DR. Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res. 2009;467(4):876-85. doi: 10.1007/s11999-008-0473-3. [PubMed: 18758876]. [PubMed Central: PMC2650061].
14. Giori NJ, Trousdale RT. Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):263-9. doi: 10.1097/01.blo.0000093014.90435.64. [PubMed: 14646725].
15. Ito K, Minka MA, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83(2):171-6. doi: 10.1302/0301-620x.83b2.11092. [PubMed: 11284559].
16. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: Part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;(418):67-73. Retrieved from. [PubMed: 15043095].
17. Stulberg SD. Unrecognized childhood hip disease: A major cause of idiopathic osteoarthritis of the hip. In: Cordell LD, Harris WH, Ramsey PL, MacEwen GD, editors. The hip: Proceedings of the 3rd Open Scientific Meeting of the Hip
Society. St Louis, MO: CV Mosby; 1975. p. 212-28.
18. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986;(213):20-33. Retrieved from. [PubMed: 3780093].
19. Siebenrock KA, Wahab KH, Werlen S, Kalhor M, Leunig M, Ganz R. Abnormal extension of the femoral head epiphysis as a cause of cam impingement. Clin Orthop Relat Res. 2004;(418):54-60. doi: 10.1097/00003086-200401000-00010. [PubMed: 15043093].
20. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br. 1999;81(2):281-8. doi: 10.1302/0301-620x.81b2.8291. [PubMed: 10204935].
21. Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999;(363):93-9. Retrieved from. [PubMed: 10379309].
22. Sutton R, Azboy I, Restrepo C, Parvizi J. Ptosis of the hip: A new
radiographic finding in patients undergoing femoroacetabular osteoplasty. J Hip Preserv Surg. 2018;5(4):425-34. doi: 10.1093/jhps/hny039. [PubMed: 30647934]. [PubMed Central: PMC6328752].
23. Saito M, Tsukada S, Yoshida K, Okada Y, Tasaki A. Correlation of alpha angle between various radiographic projections and radial magnetic resonance imaging for cam deformity in femoral head-neck junction. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):77-83. doi: 10.1007/s00167-016-4046-9. [PubMed: 26878850].
24. Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77(7):985-9. doi: 10.2106/00004623-199507000-00002. [PubMed: 7608241].
25. Tonnis D, Heinecke A. Acetabular and femoral anteversion: Relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81(12):1747-70. doi: 10.2106/00004623-199912000-00014. [PubMed: 10608388].
26. Meyer DC, Beck M, Ellis T, Ganz R, Leunig M. Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006;445:181-5. doi: 10.1097/01.blo.0000201168.72388.24. [PubMed: 16456309].
27. Pitt MJ, Graham AR, Shipman JH, Birkby W. Herniation pit of the femoral neck. AJR Am J Roentgenol. 1982;138(6):1115-21. doi: 10.2214/ajr.138.6.1115. [PubMed: 6979213].
28. Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R. Fibrocystic changes at anterosuperior femoral neck: Prevalence in hips with femoroacetabular impingement. Radiology. 2005;236(1):237-46. doi: 10.1148/radiol.2361040140. [PubMed: 15987977].
| Files | ||
| Issue | Vol 8, No 1 (2022) | |
| Section | Review Article | |
| DOI | https://doi.org/10.18502/jost.v8i1.9037 | |
| Keywords | ||
| Femur; Acetabulum; Hip; Radiography | ||
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How to Cite
1.
Moazen Jamshidi MM, Moharrami A, Poopak AH, Mafi AH, Mafi AR. Femoroacetabular Impingement Radiographic Diagnosis: A Current Concept Review. J Orthop Spine Trauma. 2022;8(1):1-4.
