Association of clinical and radiographic signs of femoroacetabular impingement in the general population

J Orthop Sci. 2017 Jan;22(1):94-98. doi: 10.1016/j.jos.2016.09.014. Epub 2016 Nov 4.

Abstract

Background: The relationships between the clinical and radiographic signs of femoroacetabular impingement (FAI) are unknown. The purpose of this study was to assess the relationship between hip pain, a positive anterior impingement sign (AIS), and radiographic signs of FAI in a general Japanese population.

Methods: A total of 616 individuals participated in this study. Hip pain was assessed using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) pain category score and the AIS was used as a provocation test. Participants were divided into a positive AIS group (at least one positive hip) and a negative AIS group. Radiographs were assessed for the cross-over sign (COS), ischial spine sign (ISS), posterior wall sign (PWS), and pistol grip deformity (PGD). Then, the relationships between the clinical and radiographic signs of FAI were evaluated.

Results: JHEQ pain scores did not differ between men and women. Seven men (3.4%) and 29 women (7.1%) had a least one hip with a positive AIS. The mean JHEQ pain scores were 22.9 ± 7.2 for the positive and 27.3 ± 2.2 for the negative AIS group (P < 0.01). The prevalences of COS, ISS, PWS, and PGD were 8.9%, 17.2%, 21.8%, and 1.9%, respectively. There were no significant associations between degree of hip pain, AIS, and each radiographic finding.

Conclusions: Radiographic signs of FAI were not associated with the degree of hip pain or a positive AIS, which suggests that radiographic findings may not be important in the clinical diagnosis of FAI.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Arthralgia / diagnosis
  • Arthralgia / etiology
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Femoracetabular Impingement / diagnostic imaging*
  • Femoracetabular Impingement / physiopathology*
  • Hip Joint / diagnostic imaging
  • Hip Joint / physiopathology
  • Humans
  • Japan
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Physical Examination / methods*
  • Radiography / methods*
  • Range of Motion, Articular / physiology*
  • Statistics, Nonparametric
  • Surveys and Questionnaires*