Clinical presentation of patients with symptomatic anterior hip impingement

Clin Orthop Relat Res. 2009 Mar;467(3):638-44. doi: 10.1007/s11999-008-0680-y. Epub 2009 Jan 7.


Femoroacetabular impingement (FAI) is considered a cause of labrochondral disease and secondary osteoarthritis. Nevertheless, the clinical syndrome associated with FAI is not fully characterized. We determined the clinical history, functional status, activity status, and physical examination findings that characterize FAI. We prospectively evaluated 51 patients (52 hips) with symptomatic FAI. Evaluation of the clinical history, physical exam, and previous treatments was performed. Patients completed demographic and validated hip questionnaires (Baecke et al., SF-12, Modified Harris hip, and UCLA activity score). The average patient age was 35 years and 57% were male. Symptom onset was commonly insidious (65%) and activity-related. Pain occurred predominantly in the groin (83%). The mean time from symptom onset to definitive diagnosis was 3.1 years. Patients were evaluated by an average 4.2 healthcare providers prior to diagnosis and inaccurate diagnoses were common. Thirteen percent had unsuccessful surgery at another anatomic site. On exam, 88% of the hips were painful with the anterior impingement test. Hip flexion and internal rotation in flexion were limited to an average 97 degrees and 9 degrees, respectively. The patients were relatively active, yet demonstrated restrictions of function and overall health. These data may facilitate diagnosis of this disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acetabulum* / diagnostic imaging
  • Acetabulum* / physiopathology
  • Adolescent
  • Adult
  • Arthrography
  • Disability Evaluation
  • Female
  • Femur Head* / diagnostic imaging
  • Femur Head* / physiopathology
  • Hip Joint* / diagnostic imaging
  • Hip Joint* / physiopathology
  • Humans
  • Joint Diseases / complications
  • Joint Diseases / diagnosis*
  • Joint Diseases / physiopathology
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain Measurement
  • Physical Examination
  • Predictive Value of Tests
  • Prospective Studies
  • Range of Motion, Articular
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Walking
  • Young Adult