Skip to main content
Top
Published in: MUSCULOSKELETAL SURGERY 2/2013

01-08-2013 | Review

Femoroacetabular impingement: role of imaging

Authors: E. Genovese, S. Spiga, V. Vinci, A. Aliprandi, F. Di Pietto, F. Coppolino, M. Scialpi, M. Giganti

Published in: MUSCULOSKELETAL SURGERY | Special Issue 2/2013

Login to get access

Abstract

The femoroacetabular impingement (FAI) is an impingement characterized by repetitive abutment between the femur and the acetabular rim during hip motion due to loss of joint clearance (Imam and Khanduja in Int Orthop 35(10):1427–1435, 2011; James et al. in AJR Am J Roentgenol 187(6):1412–1419, 2006). Femoroacetabular impingement (FAI) can be classified as either cam or pincer type, and it can be differentiated on the basis of a predominance of either a femoral or an acetabular abnormality (Pfirrmann et al. in Radiology 244(2):626, 2007; Ganz et al. in Clin Orthop Relat Res 466(2):264–272, 2008). In cases of cam FAI, the nonspherical shape of the femoral head at the femoral head–neck junction and reduced depth of the femoral waist lead to abutment of the femoral head–neck junction against the acetabular rim. In cases of pincer FAI, acetabular overcoverage limits the range of motion and leads to a conflict between the acetabulum and the femur. The most important role of preoperative MR evaluation in patients affected by FAI is the accurate assessment of the damage’s extension.
Literature
2.
go back to reference James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA (2006) MRI findings of femoroacetabular impingement. AJR Am J Roentgenol 187(6):1412–1419PubMedCrossRef James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA (2006) MRI findings of femoroacetabular impingement. AJR Am J Roentgenol 187(6):1412–1419PubMedCrossRef
3.
go back to reference Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J (2006) Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 240(3):778–785. Erratum in: Radiology. 2007 244(2):626PubMedCrossRef Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J (2006) Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 240(3):778–785. Erratum in: Radiology. 2007 244(2):626PubMedCrossRef
5.
go back to reference Kantarci F, Ozpeynirci Y, Unlu M, Gulsen F, Ozbayrak M, Botanlioglu H, Inan M, Mihmanli I, Cantasdemir M (2012) Cross-sectional area of the labrum: role in the diagnosis of anterior acetabular labral tears. Eur Radiol 22(6):1350–1356. doi:10.1007/s00330-012-2384-7 PubMedCrossRef Kantarci F, Ozpeynirci Y, Unlu M, Gulsen F, Ozbayrak M, Botanlioglu H, Inan M, Mihmanli I, Cantasdemir M (2012) Cross-sectional area of the labrum: role in the diagnosis of anterior acetabular labral tears. Eur Radiol 22(6):1350–1356. doi:10.​1007/​s00330-012-2384-7 PubMedCrossRef
7.
go back to reference Schmid MR, Nötzli HP, Zanetti M, Wyss TF, Hodler J (2003) Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 226(2):382–386PubMedCrossRef Schmid MR, Nötzli HP, Zanetti M, Wyss TF, Hodler J (2003) Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 226(2):382–386PubMedCrossRef
9.
go back to reference Reichenbach S, Jüni P, Werlen S, Nüesch E, Pfirrmann CW, Trelle S, Odermatt A, Hofstetter W, Ganz R, Leunig M (2010) Prevalence of cam-type deformity on hip magnetic resonance imaging in young males: a cross-sectional study. Arthritis Care Res (Hoboken) 62(9):1319–1327. doi:10.1002/acr.20198 CrossRef Reichenbach S, Jüni P, Werlen S, Nüesch E, Pfirrmann CW, Trelle S, Odermatt A, Hofstetter W, Ganz R, Leunig M (2010) Prevalence of cam-type deformity on hip magnetic resonance imaging in young males: a cross-sectional study. Arthritis Care Res (Hoboken) 62(9):1319–1327. doi:10.​1002/​acr.​20198 CrossRef
10.
go back to reference Reichenbach S, Leunig M, Werlen S, Nüesch E, Pfirrmann CW, Bonel H, Odermatt A, Hofstetter W, Ganz R, Jüni P (2011) Association between cam-type deformities and magnetic resonance imaging-detected structural hip damage: a cross-sectional study in young men. Arthritis Rheum 63(12):4023–4030. doi:10.1002/art.30589 PubMedCrossRef Reichenbach S, Leunig M, Werlen S, Nüesch E, Pfirrmann CW, Bonel H, Odermatt A, Hofstetter W, Ganz R, Jüni P (2011) Association between cam-type deformities and magnetic resonance imaging-detected structural hip damage: a cross-sectional study in young men. Arthritis Rheum 63(12):4023–4030. doi:10.​1002/​art.​30589 PubMedCrossRef
11.
go back to reference Zlatkin MB, Pevsner D, Sanders TG, Hancock CR, Ceballos CE, Herrera MF (2010) Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy—a preliminary study. AJR Am J Roentgenol 194(3):709–714. doi:10.2214/AJR.07.3669 PubMedCrossRef Zlatkin MB, Pevsner D, Sanders TG, Hancock CR, Ceballos CE, Herrera MF (2010) Acetabular labral tears and cartilage lesions of the hip: indirect MR arthrographic correlation with arthroscopy—a preliminary study. AJR Am J Roentgenol 194(3):709–714. doi:10.​2214/​AJR.​07.​3669 PubMedCrossRef
12.
go back to reference Bencardino JT, Kassarjian A, Vieira RL, Schwartz R, Mellado JM, Kocher M (2011) Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain. Skelet Radiol 40(4):415–421. doi:10.1007/s00256-010-1024-z CrossRef Bencardino JT, Kassarjian A, Vieira RL, Schwartz R, Mellado JM, Kocher M (2011) Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain. Skelet Radiol 40(4):415–421. doi:10.​1007/​s00256-010-1024-z CrossRef
13.
go back to reference Bittersohl B, Steppacher S, Haamberg T, Kim YJ, Werlen S, Beck M, Siebenrock KA, Mamisch TC (2009) Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Osteoarthr Cartil 17(10):1297–1306. doi:10.1016/j.joca.2009.04.016 PubMedCrossRef Bittersohl B, Steppacher S, Haamberg T, Kim YJ, Werlen S, Beck M, Siebenrock KA, Mamisch TC (2009) Cartilage damage in femoroacetabular impingement (FAI): preliminary results on comparison of standard diagnostic vs delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Osteoarthr Cartil 17(10):1297–1306. doi:10.​1016/​j.​joca.​2009.​04.​016 PubMedCrossRef
14.
go back to reference Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res (417):112–120 (review) Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res (417):112–120 (review)
15.
go back to reference Beaulé PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ (2005) Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res 23(6):1286–1292PubMed Beaulé PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ (2005) Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res 23(6):1286–1292PubMed
16.
go back to reference Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE (2005) Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 236(2):588–592PubMedCrossRef Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE (2005) Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 236(2):588–592PubMedCrossRef
17.
go back to reference Barton C, Salineros MJ, Rakhra KS, Beaulé PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469. doi:10.1007/s11999-010-1624-x PubMedCrossRef Barton C, Salineros MJ, Rakhra KS, Beaulé PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469. doi:10.​1007/​s11999-010-1624-x PubMedCrossRef
20.
go back to reference Anderson LA, Peters CL, Park BB, Stoddard GJ, Erickson JA, Crim JR (2009) Acetabular cartilage delamination in femoroacetabular impingement. Risk factors and magnetic resonance imaging diagnosis. J Bone Joint Surg Am 91(2):305–313. doi:10.2106/JBJS.G.01198 PubMedCrossRef Anderson LA, Peters CL, Park BB, Stoddard GJ, Erickson JA, Crim JR (2009) Acetabular cartilage delamination in femoroacetabular impingement. Risk factors and magnetic resonance imaging diagnosis. J Bone Joint Surg Am 91(2):305–313. doi:10.​2106/​JBJS.​G.​01198 PubMedCrossRef
21.
go back to reference Grassi R, Lombardi G, Reginelli A, Capasso F, Romano F, Floriani I, Colacurci N (2007) Coccygeal movement: assessment with dynamic MRI. Eur J Radiol 61(3):473–479PubMedCrossRef Grassi R, Lombardi G, Reginelli A, Capasso F, Romano F, Floriani I, Colacurci N (2007) Coccygeal movement: assessment with dynamic MRI. Eur J Radiol 61(3):473–479PubMedCrossRef
22.
go back to reference Muto M, Perrotta V, Guarnieri G, Lavanga A, Vassallo P, Reginelli A, Rotondo A (2008) Vertebroplasty and kyphoplasty: friends or foes? Radiol Med 113(8):1171–1184PubMedCrossRef Muto M, Perrotta V, Guarnieri G, Lavanga A, Vassallo P, Reginelli A, Rotondo A (2008) Vertebroplasty and kyphoplasty: friends or foes? Radiol Med 113(8):1171–1184PubMedCrossRef
23.
go back to reference Macarini L, Muscarella S, Lelario M, Stoppino L, Scalzo G, Scelzi A, Armillotta M, Sforza N, Vinci R (2011) Rotator cable at MR imaging: considerations on morphological aspects and biomechanical role. Radiol Med 116(1):102–113PubMedCrossRef Macarini L, Muscarella S, Lelario M, Stoppino L, Scalzo G, Scelzi A, Armillotta M, Sforza N, Vinci R (2011) Rotator cable at MR imaging: considerations on morphological aspects and biomechanical role. Radiol Med 116(1):102–113PubMedCrossRef
24.
go back to reference Macarini L, Murrone M, Marini S, Mocci A, Ettorre GC (2004) MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws. Radiol Med 107(1–2):47–57PubMed Macarini L, Murrone M, Marini S, Mocci A, Ettorre GC (2004) MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws. Radiol Med 107(1–2):47–57PubMed
25.
go back to reference Krokidis M, Orgera G, Rossi M, Matteoli M, Hatzidakis A (2013) Interventional radiology in the management of benign biliary stenoses, biliary leaks and fistulas: a pictorial review. Insights into Imaging 4(1):77–84PubMedCrossRef Krokidis M, Orgera G, Rossi M, Matteoli M, Hatzidakis A (2013) Interventional radiology in the management of benign biliary stenoses, biliary leaks and fistulas: a pictorial review. Insights into Imaging 4(1):77–84PubMedCrossRef
26.
go back to reference Panzer S, Augat P, Esch U (2008) CT assessment of herniation pits: prevalence, characteristics, and potential association with morphological predictors of femoroacetabular impingement. Eur Radiol 18(9):1869–1875. doi:10.1007/s00330-008-0952-7 PubMedCrossRef Panzer S, Augat P, Esch U (2008) CT assessment of herniation pits: prevalence, characteristics, and potential association with morphological predictors of femoroacetabular impingement. Eur Radiol 18(9):1869–1875. doi:10.​1007/​s00330-008-0952-7 PubMedCrossRef
27.
go back to reference Wagner FV, Negrão JR, Campos J, Ward SR, Haghighi P, Trudell DJ, Resnick D (2012) Capsular ligaments of the hip: anatomic, histologic, and positional study in cadaveric specimens with MR arthrography. Radiology 263(1):189–198. doi:10.1148/radiol.12111320 PubMedCrossRef Wagner FV, Negrão JR, Campos J, Ward SR, Haghighi P, Trudell DJ, Resnick D (2012) Capsular ligaments of the hip: anatomic, histologic, and positional study in cadaveric specimens with MR arthrography. Radiology 263(1):189–198. doi:10.​1148/​radiol.​12111320 PubMedCrossRef
28.
29.
go back to reference Blankenbaker DG, De Smet AA, Keene JS, Fine JP (2007) Classification and localization of acetabular labral tears. Skelet Radiol 36(5):391–397CrossRef Blankenbaker DG, De Smet AA, Keene JS, Fine JP (2007) Classification and localization of acetabular labral tears. Skelet Radiol 36(5):391–397CrossRef
30.
go back to reference Czerny C, Hofmann S, Neuhold A, Tschauner C, Engel A, Recht MP, Kramer J (1996) Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology 200(1):225–230PubMed Czerny C, Hofmann S, Neuhold A, Tschauner C, Engel A, Recht MP, Kramer J (1996) Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology 200(1):225–230PubMed
31.
go back to reference Basile A, Tsetis D, Cavalli M, Fiumara P, Di Raimondo F, Coppolino F, Coppolino C, Mundo E, Desiderio C, Granata A, Patti MT (2010) Sacroplasty for local or massive localization of multiple myeloma. Cardiovasc Interv Radiol 33(6):1270–1277CrossRef Basile A, Tsetis D, Cavalli M, Fiumara P, Di Raimondo F, Coppolino F, Coppolino C, Mundo E, Desiderio C, Granata A, Patti MT (2010) Sacroplasty for local or massive localization of multiple myeloma. Cardiovasc Interv Radiol 33(6):1270–1277CrossRef
32.
go back to reference Colao A, Marzullo P, Vallone G, Giaccio A, Ferone D, Rossi E, Scarpa R, Smaltino F, Lombardi G (1999) Ultrasonographic evidence of joint thickening reversibility in acromegalic patients treated with lanreotide for 12 months. Clin Endocrinol (Oxf) 51(5):611–618CrossRef Colao A, Marzullo P, Vallone G, Giaccio A, Ferone D, Rossi E, Scarpa R, Smaltino F, Lombardi G (1999) Ultrasonographic evidence of joint thickening reversibility in acromegalic patients treated with lanreotide for 12 months. Clin Endocrinol (Oxf) 51(5):611–618CrossRef
33.
go back to reference Colao A, Pivonello R, Scarpa R, Vallone G, Ruosi C, Lombardi G (2005) The acromegalic arthropathy. J Endocrinol Invest 28(8 Suppl):24–31PubMed Colao A, Pivonello R, Scarpa R, Vallone G, Ruosi C, Lombardi G (2005) The acromegalic arthropathy. J Endocrinol Invest 28(8 Suppl):24–31PubMed
34.
go back to reference Nurzynska D, DiMeglio F, Castaldo C, Latino F, Romano V, Miraglia R, Guerra G, Brunese L, Montagnani S (2012) Flatfoot in children: anatomy of decision making. Ital J Anat Embryol 117(2):98–106PubMed Nurzynska D, DiMeglio F, Castaldo C, Latino F, Romano V, Miraglia R, Guerra G, Brunese L, Montagnani S (2012) Flatfoot in children: anatomy of decision making. Ital J Anat Embryol 117(2):98–106PubMed
35.
go back to reference Pinto A, Brunese L, Pinto F, Reali R, Daniele S, Romano L (2012) The concept of error and malpractice in radiology. Semin Ultrasound CT MRI 33(4):275–279CrossRef Pinto A, Brunese L, Pinto F, Reali R, Daniele S, Romano L (2012) The concept of error and malpractice in radiology. Semin Ultrasound CT MRI 33(4):275–279CrossRef
37.
go back to reference Kang AC, Gooding AJ, Coates MH, Goh TD, Armour P, Rietveld J (2010) Computed tomography assessment of hip joints in asymptomatic individuals in relation to femoroacetabular impingement. Am J Sports Med 38(6):1160–1165. doi:10.1177/0363546509358320 PubMedCrossRef Kang AC, Gooding AJ, Coates MH, Goh TD, Armour P, Rietveld J (2010) Computed tomography assessment of hip joints in asymptomatic individuals in relation to femoroacetabular impingement. Am J Sports Med 38(6):1160–1165. doi:10.​1177/​0363546509358320​ PubMedCrossRef
38.
go back to reference Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 84(4):556–560PubMedCrossRef Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 84(4):556–560PubMedCrossRef
41.
go back to reference Lohan DG, Seeger LL, Motamedi K, Hame S, Sayre J (2009) Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer? Skelet Radiol 38(9):855–862. doi:10.1007/s00256-009-0745-3 CrossRef Lohan DG, Seeger LL, Motamedi K, Hame S, Sayre J (2009) Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer? Skelet Radiol 38(9):855–862. doi:10.​1007/​s00256-009-0745-3 CrossRef
Metadata
Title
Femoroacetabular impingement: role of imaging
Authors
E. Genovese
S. Spiga
V. Vinci
A. Aliprandi
F. Di Pietto
F. Coppolino
M. Scialpi
M. Giganti
Publication date
01-08-2013
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue Special Issue 2/2013
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-013-0283-y

Other articles of this Special Issue 2/2013

MUSCULOSKELETAL SURGERY 2/2013 Go to the issue