Femoral Neck Exostosis, a Manifestation of Cam/Pincer Combined Femoroacetabular Impingement

Fritz, Anto; Reddy, D. R.; Meehan, John P.; Jamali, Amir A.

doi:10.1016/j.arthro.2009.04.076

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…Other MRI alterations consistent with FAI considered by the examining radiologists were osseous bump, 18 synovial pit, 6 , 7 , 14 , 19 , 20 , 21 , 22 bone edema in the femoral neck, acetabular osteitis and lesions of the labrum and/or acetabular cartilage.…”

Section: Methodsmentioning

confidence: 88%

Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation

Yépez

Abreu

Germani

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo determine the prevalence of femoroacetabular impingement morphology (FAIM), cam- or pincer-type, by magnetic resonance imaging (MRI) in asymptomatic adolescent soccer players, and to evaluate the possible correlation between alterations on MRI and clinical examination findings.MethodsA cross-sectional study was conducted to determine the prevalence of FAIM in asymptomatic youth soccer players aged 13–18 years. A total of 112 hips in 56 players (mean age 15.3 years) were evaluated by MRI. Images were examined by two musculoskeletal radiologists for signs of FAIM. Cam-type (impingement) deformity was diagnosed by alpha angle ≥55° or head–neck offset <7 mm. Pincer-type (impingement) deformity was diagnosed by center-edge angle (CEA) ≥35° or acetabular index ≤0°. Other MRI changes, characteristic of FAIM, were observed. Clinical examination was performed to determine the range of motion (ROM) of the hips. In addition, specific tests for anterolateral and posteroinferior impingement were performed.ResultsThe prevalence of MRI findings consistent with FAIM among this young population was 84.8% (95/112). The alpha angle was ≥55° in 77.7% (87/112) of hips, while the CEA was altered in 10.7% (12/112) of hips. Qualitative MRI findings consistent with FAIM were highly prevalent, and included loss of sphericity of the femoral head (77%), osseous bump (44%), femoral neck edema (21%), and acetabular osteitis (9%). The anterior impingement test was positive in 15% of the hips evaluated.ConclusionYouth soccer players have a high prevalence of FAIM as diagnosed by MRI. There is no correlation between physical examination findings and MRI evidence of FAIM in this population.

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Section: Methodsmentioning

confidence: 88%

Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation

Yépez

Abreu

Germani

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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“…A ratio of ≤1.27 was considered abnormal. 6 Other suggestive signs of the cam variant are FPFN (defined as an exostosis in the femoral neck) 12 (Figure 3B) and LFFH (flattening along the femoral head-neck junction and, in severe cases, loss of differentiation between them) 23 (Figure 3C), both of which were determined by the presence of the deformity on radiographs by direct observation; however, it has been recognized that these are not present in all cases of cam - type variants. 23 The reviewers considered these signs to be either positive or negative, and disagreements were resolved by a consensus.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

Morales-Ávalos

Tapia-Náñez

Simental‐Mendía

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Radiographic findings related to the cam and pincer variants of femoroacetabular impingement (FAI) include measurements of the alpha angle and lateral center-edge angle (LCEA). The function of these radiographic findings has been put into question because of high heterogeneity in reported studies. Purpose: The aim of this study was 3-fold: (1) to determine the prevalence of cam and pincer variants according to sex and age on anteroposterior (AP) pelvic radiographs from an asymptomatic nonathletic population, (2) to identify the most common radiographic signs of cam- and pincer-type variants, and (3) to determine if there are variations in the prevalence of these radiographic signs according to sex and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: There were 3 independent observers who retrospectively analyzed the 939 AP pelvic radiographs (1878 hips) of patients aged 18 to 50 years who did not have hip symptoms and who were not professional athletes. The prevalence of the cam and pincer variants according to the alpha angle and LCEA, respectively, and the presence of other radiographic signs commonly associated with these variables were determined in the overall population and by subgroup according to sex and age group (18-30, 31-40, and 41-50 years). Descriptive and inferential statistics were used to analyze the study sample. Results: The mean age of the included population was 31.0 ± 9.2 years, and 68.2% were male. The prevalence of the cam-type variant was 29.7% (558/1878), and that of the pincer-type variant was 24.3% (456/1878). The radiographic signs that were most associated with the cam and pincer variants were a pistol-grip deformity and the crossover sign, respectively. Significant differences ( P < .001) in the prevalence of these variants were identified between men and women in both variants. No differences were observed in the alpha angle or LCEA according to sex or age. Conclusion: Radiographic findings suggestive of FAI had significant variations with respect to sex and age in this study sample. This study provides information to determine the prevalence of these anatomic variants in the general population.

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“…Further, the location of intra‐articular pathology is elusive, and thus, analysing the exact biomechanics of the physical examination may be helpful in understanding the physical examination manoeuvres. To overcome this issue, different approaches have been proposed: computer simulation, imaging and physical examination [3, 7, 13, 16, 24, 25, 28, 30, 32].…”

Section: Introductionmentioning

confidence: 99%

Relationship between femoroacetabular contact areas and hip position in the normal joint: an in vitro evaluation

Signorelli

Lopomo

Bonanzinga

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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Femoral Neck Exostosis, a Manifestation of Cam/Pincer Combined Femoroacetabular Impingement

Cited by 9 publications

References 26 publications

Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation

Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation

Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

Relationship between femoroacetabular contact areas and hip position in the normal joint: an in vitro evaluation

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