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Normal hip xray review3/29/2024 For instance, younger athletes, or those participating in high-intensity sports such as soccer, hockey, basketball, and football, have higher rates of FAIS and OA. 1,6,10 Nonetheless, recent studies have examined FAIS incidence in specific populations. 6 EpidemiologyįAIS epidemiology is challenging to quantify because current studies either lack power, use differing radiographic criteria, or do not adhere to the diagnostic triad when examining populations. Management consists of conservative therapy (activity modification, oral medications, physical therapy) or surgical options, with the latter reserved for patients that fail conservative treatment or present initially with severe symptoms. A combination of both cam and pincer deformities, referred to as mixed, is the most common presentation. 1,9 Severity is measured with two calculated angles: the alpha (α) and lateral central-edge angles (LCEA) for cam and pincer lesions, respectively. 6,8 Pincer deformity describes excess coverage of the acetabulum over the femoral head, which can be secondary to coxa profunda or acetabular retroversion. Cam deformity is from decreased head-neck offset or an abnormally shaped femoral head, with convexities and bony deposition occurring at the head-neck junction, most commonly in the anterosuperior region. ![]() 5,7 The FAIS morphologies can be divided into cam, pincer, or mixed. ![]() 1,6 Anterior-posterior (AP) radiographs are used to identify the specific osseous changes and rule out other origins of hip pain. Patients also frequently report “clicking, catching, locking, stiffness.” 6 Patient often present with decreased range of motion (ROM), especially flexion and internal rotation, and positive impingement tests (i.e., Flexion Abduction External Rotation (FABER) and Flexion Adduction Internal Rotation (FADIR)). The symptoms include hip/groin pain aggravated by activity or sitting, commonly with referral to the buttocks, thighs, or knees. 5 FAIS consists of a triad of specific symptoms, clinical signs, and particular bony deformities. 3 and Sankar et al., 4 but it was not until 2016 that a consensus regarding the proper diagnosis of FAI syndrome (FAIS) was established. FAI often leads to labral, cartilaginous, and tissue damage that predispose this patient population to early osteoarthritis (OA). The most common surgical treatment option for FAI is done arthroscopically.įemoroacetabular impingement (FAI) is a chronic hip condition caused by femoral head and acetabular malformations resulting in irregular forces and contact across the joint and bones. Conservative treatment is typically considered first-line treatment for mild to moderate FAI syndrome however, the outcomes following postoperative surgical intervention have demonstrated excellent results. The primary imaging modality for diagnosing FAI is a plain radiograph of the pelvis, which can be used to measure the alpha angle and the lateral center edge angle used to quantify severity. This classification refers to the characteristic morphological changes of the bony structures. ![]() FAI syndrome can be organized into three classifications cam, pincer, or mixed. On physical examination, patients will typically have a positive FADIR test (flexion, adduction, internal rotation), also known as a positive impingement sign. Slow-onset, persistent groin pain is the most frequent initial presenting symptom. There are a variety of factors that increase the risk for FAI including younger age, Caucasian background, familial FAIS morphology, and competing in high-intensity sports during adolescence. Femoroacetabular impingement (FAI) is a chronic hip condition caused by femoral head and acetabular malformations resulting in abnormal contact across the joint.
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