Hip Pelvis.  2014 Jun;26(2):115-123. 10.5371/hp.2014.26.2.115.

Correlation of Structural Bony Abnormalities and Mechanical Symptoms of Hip Joints

• Lyu SH
• Kwak YH
• Lee YK
• Ha YC
• Koo KH

• KMID: 2054173
• DOI: http://doi.org/10.5371/hp.2014.26.2.115

Abstract

PURPOSE
The purpose of this study is to determine structural bony abnormalities predisposing for femoroacetabular impingement by comparison of patients with and without mechanical symptoms.
MATERIALS AND METHODS
We conducted this comparative study on 151 patients (151 hips; mean age 44.8 years; range 16-73 years) with mechanical symptoms with results of multi-detector computed tomography (MDCT) arthrography (the symptomatic group). Each patient was matched with a control who underwent MDCT due to ureter stone (the asymptomatic group) in terms of age, gender, site (right or left), and time at diagnosis. Acetabular evaluations, which included cranial and central anteversion and anterior and lateral center edge angles and femoral measurements, were performed. In addition, we evaluated the prevalence and characteristics of structural bone abnormalities between the two groups.
RESULTS
The prevalence for patients who had at least one structural bony abnormality in the symptomatic and asymptomatic groups was 80.1% (121/151) and 54.3% (82/151), respectively (odds ratio: 3.39, 95% confidence interval: 2.30-5.66; P<0.001). The most common osseous abnormality was the isolated Pincer type in both groups: 89 (73.6%) of 121 hips with an osseous abnormality in the symptomatic group and 57 (69.5%) of 82 hips with an osseous abnormality in the asymptomatic group. By analysis of CT arthrography in symptomatic patients, a labral tear was found in 107 hips (70.9%), and 86 (80%) of these hips had a structural bony abnormality.
CONCLUSION
A significantly greater prevalence rate of structural bony abnormality was observed for the symptomatic group than for the asymptomatic group. These findings are helpful for development of appropriate treatment plans.

Keyword

Femoroacetabular impingement; Multidetector computed tomography; Arthrography

MeSH Terms

Acetabulum
Arthrography
Diagnosis
Femoracetabular Impingement
Hip
Hip Joint*
Humans
Multidetector Computed Tomography
Prevalence
Ureter

Figure

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  Fig. 1 Alpha angle measurement with reformatted pelvis multi-detector computed tomography scan.

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  Fig. 2 Assessment parameters with using multi-detector computed tomography arthrography. (A) Neck shaft angle, (B) lateral center edge angle, (C) alpha angle, (D) anterior center edge angle, (E) central acetabular version, (F) cranial acetabular version, and (G) labral abnormality (arrow).

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