The frequency of sequelae of slipped upper femoral epiphysis in cam-type femoroacetabular impingement

Murgier, Jérôme; Reina, Nicolas; Cavaignac, Étienne; Espié, A.; Bayle-Iniguez, Xavier; Chiron, Philippe

doi:10.1302/0301-620x.96b6.33000

Cited by 14 publications

(6 citation statements)

References 57 publications

(60 reference statements)

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“…A prevalence of 13% was found for healthy young adults [9]: 35% to 68% in hips with osteoarthritis requiring THA [6,14] and 8% in anatomic specimens [7]. The only study investigating prevalence in hips with cam-type FAI without advanced osteoarthritis reported a prevalence of 44%, which is higher than in our cohort [15]. The reason for this difference might be related to the use of a single parameter based only on 2-D radiographs in other studies.…”

Section: ) (B)contrasting

confidence: 56%

“…The four study groups differed in terms of age at the acquisition of the MRI, weight, and body mass index (BMI) ( Table 1). The normal group showed a decreased age (17 ± 2 [range, [15][16][17][18][19][20] years) compared with the other study groups (mean age ranging from 24 to 25 years; p ranging from \ 0.001 to 0.002). In the normal group, both weight (66 ± 14 [48-95] kg) and BMI (22 ± 3.4 [18][19][20][21][22][23][24][25][26][27][28] kg/m 2 ) were decreased compared with the idiopathic cam (p = 0.028 and p = 0.002, respectively) and slip-like group (both p = 0.001; Table 1).…”

Section: Methodsmentioning

confidence: 77%

“…1). Such a slip-like morphology has already been described in previous studies based on an osteologic collection [7] or conventional radiographs [13,15]. Drawbacks of these studies included lack of clinical information [7], a potential influence of secondary degenerative changes [14], and/or the use of two-dimensional (2-D) plain radiography [13,14] to evaluate a threedimensional (3-D) problem.…”

Section: Introductionmentioning

confidence: 79%

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Twelve Percent of Hips With a Primary Cam Deformity Exhibit a Slip-like Morphology Resembling Sequelae of Slipped Capital Femoral Epiphysis

Albers

Steppacher

Haefeli

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background In some hips with cam-type femoroacetabular impingement (FAI), we observed a morphology resembling a more subtle form of slipped capital femoral epiphysis (SCFE). Theoretically, the morphology in these hips should differ from hips with a primary cam-type deformity. Questions/purposes We asked if (1) head-neck offset; (2) epiphyseal angle; and (3) tilt angle differ among hips with a slip-like morphology, idiopathic cam, hips after in situ pinning of SCFE, and normal hips; and (4) what is the prevalence of a slip-like morphology among cam-type hips?Methods We retrospectively compared the three-dimensional anatomy of hips with a slip-like morphology (29 hips), in situ pinning for SCFE (eight hips), idiopathic cam deformity (171 hips), and 30 normal hips using radial MRI arthrography. Normal hips were derived from 17 asymptomatic volunteers. All other hips were recruited from a series of 277 hips (243 patients) seen at a specialized academic hip center between 2006 and 2010. Forty-one hips with isolated pincer deformity were excluded. Thirtysix of 236 hips had a known cause of cam impingement (secondary cam), including eight hips after in situ pinning of SCFE (postslip group). The 200 hips with a primary cam were separated in hips with a slip-like morphology (combination of positive fovea sign [if the neck axis did not intersect with the fovea capitis] and a tilt angle [between the neck axis and perpendicular to the basis of the epiphysis] exceeding 4°) and hips with an idiopathic cam. We evaluated offset ratio, epiphyseal angle (angle between the neck axis and line connecting the center of the femoral head and the point where the physis meets the articular surface), and tilt angle circumferentially around the femoral head-neck axis. Prevalence of slip-like morphology was determined based on the total of 236 hips with cam deformities. Results Offset ratio was decreased anterosuperiorly in idiopathic cam, slip-like, and postslip (eg, 1 o'clock position with a mean offset ranging from 0.00 to 0.14; p \ 0.001 for all groups) compared with normal hips Conclusions The slip-like morphology is the second most frequent pathomorphology in hips with primary cam deformity. MRI arthrography of the hip allows identifying a slip-like morphology, which resembles hips after in situ pinning of SCFE and distinctly differs from hips with idiopathic cam. These results support previous studies reporting that SCFE might be a risk factor for cam-type FAI. Level of Evidence Level III, prognostic study.

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Section: ) (B)contrasting

confidence: 56%

Section: Methodsmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 79%

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Twelve Percent of Hips With a Primary Cam Deformity Exhibit a Slip-like Morphology Resembling Sequelae of Slipped Capital Femoral Epiphysis

Albers

Steppacher

Haefeli

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…However, some authors believe it useful and even superior to other radiographic incidences for FAI [12,16]. Several studies have demonstrated the values of interest [2,4,5,[17][18][19]. One of its advantages is that there is no accurate coding for the classic FL.…”

Section: Discussionmentioning

confidence: 99%

Modified head-neck offset for diagnosing anterior femoro-acetabular impingement

Espié

Elia²,

Murgier³

et al. 2015

International Orthopaedics (SICOT)

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“…Slipped capital femoral epiphysis has been suggested to be one of the etiologic factors for cam-type impingement (82). Prevalence of a sliplike morphology in primary cam deformity was reported to be around 12% femur owing to a focal or general acetabular overcoverage.…”

Section: State Of the Art: Hip Imaging In Athletes Agten Et Almentioning

confidence: 99%

Hip Imaging in Athletes: Sports Imaging Series

et al. 2016

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Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam-and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam-and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. After reading the article and taking the test, the reader will be able to:n Describe biomechanical implications of torsional malalignment and other atypical forms of hip impingement n Describe the most common MR imaging findings in femoroacetabular impingement and identify anatomic variants n Describe imaging characteristics of a Morel-Lavallée lesion and identify the anatomic compartment where this lesion typically occurs n Identify common stress fractures around the hip joint in athletes and discuss potential complications n Describe features of myotendinous injuries around the hip n Describe the anatomic relationship of the sacrotuberous ligament and the origin of the hamstring tendons n Describe the anatomic structures involved in an athletic pubalgia Accreditation and Designation Statement The RSNA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The RSNA designates this journal-based SA-CME activity for a maximum of 1.0 AMA PRA Category 1 Credit ™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure StatementThe ACCME requires that the RSNA, as an accredited prov...

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The frequency of sequelae of slipped upper femoral epiphysis in cam-type femoroacetabular impingement

Cited by 14 publications

References 57 publications

Twelve Percent of Hips With a Primary Cam Deformity Exhibit a Slip-like Morphology Resembling Sequelae of Slipped Capital Femoral Epiphysis

Twelve Percent of Hips With a Primary Cam Deformity Exhibit a Slip-like Morphology Resembling Sequelae of Slipped Capital Femoral Epiphysis

Modified head-neck offset for diagnosing anterior femoro-acetabular impingement

Hip Imaging in Athletes: Sports Imaging Series

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