Cartilage delamination is common in patients undergoing surgery for FAI. Fluid under the cartilage delamination is a specific but rare finding. Hypointense areas in the acetabular cartilage seen on intermediate-weighted fat-saturated or T1-weighted images appear to be helpful diagnostic criteria.
Objective To determine the prevalence of femoroacetabular impingement (FAI) of the cam or pincer type based on magnetic resonance imaging (MRI) in a group of adult female professional ballet dancers, and to quantify, in vivo, the range of motion (ROM) and congruence of the hip joint in the splits position. Materials and methods Institutional review board approval and informed consent from each volunteer were obtained. Thirty symptomatic or asymptomatic adult female professional ballet dancers (59 hips) and 14 asymptomatic non-dancer adult women (28 hips, control group) were included in the present study. All subjects underwent MRI in the supine position, while, for the dancers, additional images were acquired in the splits position. Labral abnormalities, cartilage lesions, and osseous abnormalities of the acetabular rim were assessed at six positions around the acetabulum. A morphological analysis, consisting of the measurement of the α angle, acetabular depth, and acetabular version, was performed. For the dancers, ROM and congruency of the hip joint in the splits position were measured.Results Acetabular cartilage lesions greater than 5 mm were significantly more frequent in dancer's hips than in control hips (28.8 vs 7.1%, p=0.026), and were mostly present at the superior position in dancers. Distribution of labral lesions between the dancers and the control group showed substantially more pronounced labral lesions at the superior, posterosuperior, and anterosuperior positions in dancers (54 lesions in 28 dancer's hips vs 10 lesions in 8 control hips). Herniation pits were found significantly more often (p=0.002) in dancer's hips (n=31, 52.5%), 25 of them being located in a superior position. A cam-type morphology was found for one dancer and a retroverted hip was noted for one control. Femoroacetabular subluxations were observed in the splits position (mean: 2.05 mm). Conclusion The prevalence of typical FAI of the cam or pincer type was low in this selected population of professional ballet dancers. The lesions' distribution, mostly superior, could be explained by a "pincer-like" mechanism of impingement with subluxation in relation to extreme movements performed by the dancers during their daily activities.
Gastrocnemius lengthening was an effective treatment for chronic Achilles noninsertional tendinopathy. Two-year results show good to excellent clinical outcome.
The diagnostic performance of knee MR imaging performed by using a 3D water excitation isovoxel true FISP sequence and an imaging time of approximately 3 minutes is comparable to the diagnostic performance of the MR sequences used as standards at the authors' institution.
Three-dimensional WE true FISP enables high contrast between joint fluid and articular cartilage and a diagnostic performance that is comparable with that of standard sequences.
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