SPR Unknown #52 -- FINAL

Vishal Khiatani

UIC

khiatani@uic.edu

Mary Wyers, MD

Children's Memorial Hospital

Abstract

19 year old female with left hip pain

Keywords

CAM femoroacetabular impingement, FAI, MRI, 1706, SPR unknown 52


Publication Date: 2011-05-04

History

19 year old female distant history of hip dysplasia presents with left sided hip pain for several months. No acute injury is noted.

Findings

An osseous protuberance is noted at the left femoral head/neck junction, with mild associated cortical edema as best evidenced on fat suppressed T2/STIR images. A shortened left femoral neck is also noted.

Diagnosis

CAM type femoral acetabular impingement

DDx

None

Discussion

Femoral acetabular impingement (FAI) is a process related to excess friction of the femoral neck and acetabular roof resulting in an impingement phenomena which could lead to further injury of the hip including articular damage or labral tear.

Two major types exist, CAM and PINCER types. CAM type FAI is related to overgrowth in the femoral head/neck junction which resultantly impinges upon the acetabulum. PINCER type FAI is due to overgrowth of the acetabular roof with resultant impingement upon the femoral neck.

Radiographic findings may show protuberances at the femoral head/neck junction or overgrowth of the acetabular roof. Other findings may include subcortical lucency. MR findings include possible bone marrow edema at the site of impingement, a prominent osseous protuberance at the femoral head/neck junction, subcortical cyst formation, and possible labral tears.

Treatment is conservative in milder cases with surgical options reserved for severe cases.

References

  1. H Gabriel, S W Fitzgerald, M T Myers, J S Donaldson, and A K Poznanski MR imaging of hip disorders. Radiographics July 1994 14:763-781
  2. Bedi A, Dolan M, Leunig M, Kelly BT. Static and dynamic mechanical causes of hip pain. Arthroscopy. 2011 Feb;27(2):235-51. Epub 2010 Oct 29.
  3. Hip pain in young adults - a case report and review of the literature Baz IM, Castro M, Cabete S, Rocha JA, Brito I. Acta Reumatol Port. 2009 Oct-Dec;34(4):656-62.

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