Femoroacetabular impingement: Difference between revisions
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== | {{SI}} | ||
{{Infobox medical condition | |||
[[ | | name = Femoroacetabular impingement | ||
| synonyms = FAI | |||
| specialty = [[Orthopedic surgery]] | |||
| symptoms = [[Hip pain]], [[stiffness]], [[limitation of movement]] | |||
| complications = [[Osteoarthritis]] | |||
| onset = Typically [[young adults]] | |||
| duration = Chronic | |||
| causes = Abnormal contact between the [[femur]] and [[acetabulum]] | |||
| risks = [[Athletic activities]], [[genetic predisposition]] | |||
| diagnosis = [[Physical examination]], [[X-ray]], [[MRI]] | |||
| differential = [[Hip dysplasia]], [[labral tear]], [[osteoarthritis]] | |||
| prevention = Avoidance of activities that exacerbate symptoms | |||
| treatment = [[Physical therapy]], [[arthroscopic surgery]] | |||
| medication = [[NSAIDs]] | |||
| prognosis = Variable, depending on severity and treatment | |||
| frequency = Common in [[athletes]] | |||
}} | |||
'''Femoroacetabular impingement''' (FAI) is a condition involving abnormal contact between the [[femur]] and the [[acetabulum]] of the [[hip joint]], which can lead to joint damage and pain. This condition is often seen in young and active individuals and can be a precursor to [[osteoarthritis]] of the hip. | '''Femoroacetabular impingement''' (FAI) is a condition involving abnormal contact between the [[femur]] and the [[acetabulum]] of the [[hip joint]], which can lead to joint damage and pain. This condition is often seen in young and active individuals and can be a precursor to [[osteoarthritis]] of the hip. | ||
== Types of Impingement == | == Types of Impingement == | ||
FAI is generally classified into three types: | FAI is generally classified into three types: | ||
=== Cam Impingement === | === Cam Impingement === | ||
[[File:X-ray_of_cam.jpg|thumb | [[File:X-ray_of_cam.jpg|left|thumb|X-ray showing cam impingement]] | ||
Cam impingement occurs when the femoral head is not perfectly round and cannot rotate smoothly inside the acetabulum. This results in abnormal contact and damage to the cartilage and labrum. | Cam impingement occurs when the femoral head is not perfectly round and cannot rotate smoothly inside the acetabulum. This results in abnormal contact and damage to the cartilage and labrum. | ||
=== Pincer Impingement === | === Pincer Impingement === | ||
[[File:X-ray_of_pincer_impingement.jpg|thumb | [[File:X-ray_of_pincer_impingement.jpg|left|thumb|X-ray showing pincer impingement]] | ||
Pincer impingement is characterized by excessive coverage of the femoral head by the acetabulum. This can lead to the labrum being pinched between the acetabulum and the femoral head. | Pincer impingement is characterized by excessive coverage of the femoral head by the acetabulum. This can lead to the labrum being pinched between the acetabulum and the femoral head. | ||
=== Combined Impingement === | === Combined Impingement === | ||
In many cases, individuals may have a combination of both cam and pincer impingement, leading to a more complex clinical presentation. | In many cases, individuals may have a combination of both cam and pincer impingement, leading to a more complex clinical presentation. | ||
== Diagnosis == | == Diagnosis == | ||
Diagnosis of FAI typically involves a combination of clinical examination and imaging studies. | Diagnosis of FAI typically involves a combination of clinical examination and imaging studies. | ||
=== Clinical Examination === | === Clinical Examination === | ||
Patients often present with hip or groin pain, especially during activities that involve hip flexion. A thorough physical examination can reveal limited range of motion and pain during specific movements. | Patients often present with hip or groin pain, especially during activities that involve hip flexion. A thorough physical examination can reveal limited range of motion and pain during specific movements. | ||
=== Imaging Studies === | === Imaging Studies === | ||
==== X-rays ==== | ==== X-rays ==== | ||
X-rays are commonly used to assess the bony structures of the hip and identify signs of FAI. | X-rays are commonly used to assess the bony structures of the hip and identify signs of FAI. | ||
==== Center-Edge Angle ==== | ==== Center-Edge Angle ==== | ||
[[File:Center-edge_angle_of_Wiberg.jpg|thumb | [[File:Center-edge_angle_of_Wiberg.jpg|left|thumb|Diagram showing the center-edge angle of Wiberg]] | ||
The center-edge angle of Wiberg is used to assess the coverage of the femoral head by the acetabulum. | The center-edge angle of Wiberg is used to assess the coverage of the femoral head by the acetabulum. | ||
==== Crossing Sign ==== | ==== Crossing Sign ==== | ||
[[File:Crossing_ratio_of_the_hip.jpg|thumb | [[File:Crossing_ratio_of_the_hip.jpg|left|thumb|Diagram showing the crossing sign of the hip]] | ||
The crossing sign is an indicator of acetabular retroversion, which can be associated with pincer impingement. | The crossing sign is an indicator of acetabular retroversion, which can be associated with pincer impingement. | ||
==== Alpha Angle ==== | ==== Alpha Angle ==== | ||
[[File:Alpha_angle_measured_in_45_degrees_Dunn_view.jpg|thumb | [[File:Alpha_angle_measured_in_45_degrees_Dunn_view.jpg|left|thumb|Diagram showing the alpha angle in a 45-degree Dunn view]] | ||
The alpha angle is used to quantify the asphericity of the femoral head-neck junction, which is indicative of cam impingement. | The alpha angle is used to quantify the asphericity of the femoral head-neck junction, which is indicative of cam impingement. | ||
==== Hip Offset Percentage ==== | ==== Hip Offset Percentage ==== | ||
[[File:Hip_offset_percentage_measured_in_cross-lateral_view.jpg|thumb | [[File:Hip_offset_percentage_measured_in_cross-lateral_view.jpg|left|thumb|Diagram showing hip offset percentage]] | ||
The hip offset percentage is a measure used to evaluate the lateralization of the femoral head. | The hip offset percentage is a measure used to evaluate the lateralization of the femoral head. | ||
==== Tönnis Angle ==== | ==== Tönnis Angle ==== | ||
[[File:Tönnis_angle_of_the_hip.jpg|thumb | [[File:Tönnis_angle_of_the_hip.jpg|left|thumb|Diagram showing the Tönnis angle of the hip]] | ||
The Tönnis angle is used to assess the inclination of the acetabulum. | The Tönnis angle is used to assess the inclination of the acetabulum. | ||
== Treatment == | == Treatment == | ||
Treatment for FAI can be conservative or surgical, depending on the severity of the condition and the patient's symptoms. | Treatment for FAI can be conservative or surgical, depending on the severity of the condition and the patient's symptoms. | ||
=== Conservative Management === | === Conservative Management === | ||
Conservative treatment includes activity modification, physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and improve hip function. | Conservative treatment includes activity modification, physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and improve hip function. | ||
=== Surgical Intervention === | === Surgical Intervention === | ||
Surgical options, such as hip arthroscopy, aim to correct the bony abnormalities and repair any damage to the labrum or cartilage. | Surgical options, such as hip arthroscopy, aim to correct the bony abnormalities and repair any damage to the labrum or cartilage. | ||
== See also == | |||
== | |||
* [[Hip joint]] | * [[Hip joint]] | ||
* [[Osteoarthritis]] | * [[Osteoarthritis]] | ||
* [[Hip arthroscopy]] | * [[Hip arthroscopy]] | ||
{{Medical conditions}} | {{Medical conditions}} | ||
[[Category:Orthopedic conditions]] | [[Category:Orthopedic conditions]] | ||
[[Category:Hip disorders]] | [[Category:Hip disorders]] | ||
Latest revision as of 15:39, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Femoroacetabular impingement | |
|---|---|
| Synonyms | FAI |
| Pronounce | N/A |
| Specialty | Orthopedic surgery |
| Symptoms | Hip pain, stiffness, limitation of movement |
| Complications | Osteoarthritis |
| Onset | Typically young adults |
| Duration | Chronic |
| Types | N/A |
| Causes | Abnormal contact between the femur and acetabulum |
| Risks | Athletic activities, genetic predisposition |
| Diagnosis | Physical examination, X-ray, MRI |
| Differential diagnosis | Hip dysplasia, labral tear, osteoarthritis |
| Prevention | Avoidance of activities that exacerbate symptoms |
| Treatment | Physical therapy, arthroscopic surgery |
| Medication | NSAIDs |
| Prognosis | Variable, depending on severity and treatment |
| Frequency | Common in athletes |
| Deaths | N/A |
Femoroacetabular impingement (FAI) is a condition involving abnormal contact between the femur and the acetabulum of the hip joint, which can lead to joint damage and pain. This condition is often seen in young and active individuals and can be a precursor to osteoarthritis of the hip.
Types of Impingement[edit]
FAI is generally classified into three types:
Cam Impingement[edit]
Cam impingement occurs when the femoral head is not perfectly round and cannot rotate smoothly inside the acetabulum. This results in abnormal contact and damage to the cartilage and labrum.
Pincer Impingement[edit]
Pincer impingement is characterized by excessive coverage of the femoral head by the acetabulum. This can lead to the labrum being pinched between the acetabulum and the femoral head.
Combined Impingement[edit]
In many cases, individuals may have a combination of both cam and pincer impingement, leading to a more complex clinical presentation.
Diagnosis[edit]
Diagnosis of FAI typically involves a combination of clinical examination and imaging studies.
Clinical Examination[edit]
Patients often present with hip or groin pain, especially during activities that involve hip flexion. A thorough physical examination can reveal limited range of motion and pain during specific movements.
Imaging Studies[edit]
X-rays[edit]
X-rays are commonly used to assess the bony structures of the hip and identify signs of FAI.
Center-Edge Angle[edit]
The center-edge angle of Wiberg is used to assess the coverage of the femoral head by the acetabulum.
Crossing Sign[edit]
The crossing sign is an indicator of acetabular retroversion, which can be associated with pincer impingement.
Alpha Angle[edit]
The alpha angle is used to quantify the asphericity of the femoral head-neck junction, which is indicative of cam impingement.
Hip Offset Percentage[edit]
The hip offset percentage is a measure used to evaluate the lateralization of the femoral head.
Tönnis Angle[edit]
The Tönnis angle is used to assess the inclination of the acetabulum.
Treatment[edit]
Treatment for FAI can be conservative or surgical, depending on the severity of the condition and the patient's symptoms.
Conservative Management[edit]
Conservative treatment includes activity modification, physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and improve hip function.
Surgical Intervention[edit]
Surgical options, such as hip arthroscopy, aim to correct the bony abnormalities and repair any damage to the labrum or cartilage.
See also[edit]
