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A comparative radiographic investigation of femoroacetabular impingement in young patients with and without hip pain.

Miguel OF, Cabrita HB, Rodrigues MB, Croci AT - Clinics (Sao Paulo) (2012)

Bottom Line: The joint space measurement differed significantly between groups in the Lequesne view (p = 0.007).We conclude that the best views for diagnosing a femoroacetabular impingement are the anteroposterior pelvic orthostatic, the Dunn 45º, and the Ducroquet views.The following findings correlated with hip pain: a decrease in the femoral offset, an increase in the α angle, an increase in the Lequesne ρ angle, a decrease in the CE angle of Wiberg, a thinner articular space and the presence of a bump on the femoral head-neck transition.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, Arthroplasty Service, Brazil. omarfmiguel@gmail.com

ABSTRACT

Objective: To compare the existence of radiographic abnormalities in two groups of patients, those with and without hip pain.

Methods: A total 222 patients were evaluated between March 2007 and April 2009; 122 complained of groin pain, and 100 had no symptoms. The individuals in both groups underwent radiographic examinations of the hip using the following views: anteroposterior, Lequesne false profile, Dunn, Dunn 45º, and Ducroquet.

Results: A total of 1110 radiographs were evaluated. Female patients were prevalent in both groups (52% symptomatic, 58% asymptomatic). There were statistically significant differences between the groups in age (p<0.0001), weight (p = 0.002) and BMI (p = 0.006). The positive findings in the group with groin pain consisted of the presence of a bump on the femoral head in the anteroposterior view (p<0.0001) or in the Dunn 45º view (p = 0.008). The difference in the a angle in the anteroposterior, Dunn, Dunn 45º, and Ducroquet views for all of the cases studied was p,0.0001. The joint space measurement differed significantly between groups in the Lequesne view (p = 0.007). The Lequesne anteversion angle (ρ) and the femoral offset measurement also differed significantly (p = 0.005 and p = 0.0001, respectively).

Conclusions: We conclude that the best views for diagnosing a femoroacetabular impingement are the anteroposterior pelvic orthostatic, the Dunn 45º, and the Ducroquet views. The following findings correlated with hip pain: a decrease in the femoral offset, an increase in the α angle, an increase in the Lequesne ρ angle, a decrease in the CE angle of Wiberg, a thinner articular space and the presence of a bump on the femoral head-neck transition.

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Samples of the measurement of α and ρ angles: (A) α angle in the AP view, (B) Lequesne femoral anteversion angle (ρ) in the Lequesne false profile view, (C) α angle in the Dunn view, (D) α angle in the Dunn 45° view and (E) α angle in the Ducroquet view.
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f1-cln_67p463: Samples of the measurement of α and ρ angles: (A) α angle in the AP view, (B) Lequesne femoral anteversion angle (ρ) in the Lequesne false profile view, (C) α angle in the Dunn view, (D) α angle in the Dunn 45° view and (E) α angle in the Ducroquet view.

Mentions: AP: an orthostatic support was used to maintain the limbs at 20° of internal rotation, and the x-ray tube was centralized to the sacrum and parallel to the floor. The center-edge angle of Wiberg, the width of the joint space, the acetabular tilt (14), the acetabular retroversion or anteversion, the alpha angle (α) (6,7,13) (Figure 1A), and the presence or absence of a “bump” were evaluated.


A comparative radiographic investigation of femoroacetabular impingement in young patients with and without hip pain.

Miguel OF, Cabrita HB, Rodrigues MB, Croci AT - Clinics (Sao Paulo) (2012)

Samples of the measurement of α and ρ angles: (A) α angle in the AP view, (B) Lequesne femoral anteversion angle (ρ) in the Lequesne false profile view, (C) α angle in the Dunn view, (D) α angle in the Dunn 45° view and (E) α angle in the Ducroquet view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3351245&req=5

f1-cln_67p463: Samples of the measurement of α and ρ angles: (A) α angle in the AP view, (B) Lequesne femoral anteversion angle (ρ) in the Lequesne false profile view, (C) α angle in the Dunn view, (D) α angle in the Dunn 45° view and (E) α angle in the Ducroquet view.
Mentions: AP: an orthostatic support was used to maintain the limbs at 20° of internal rotation, and the x-ray tube was centralized to the sacrum and parallel to the floor. The center-edge angle of Wiberg, the width of the joint space, the acetabular tilt (14), the acetabular retroversion or anteversion, the alpha angle (α) (6,7,13) (Figure 1A), and the presence or absence of a “bump” were evaluated.

Bottom Line: The joint space measurement differed significantly between groups in the Lequesne view (p = 0.007).We conclude that the best views for diagnosing a femoroacetabular impingement are the anteroposterior pelvic orthostatic, the Dunn 45º, and the Ducroquet views.The following findings correlated with hip pain: a decrease in the femoral offset, an increase in the α angle, an increase in the Lequesne ρ angle, a decrease in the CE angle of Wiberg, a thinner articular space and the presence of a bump on the femoral head-neck transition.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Medicina da Universidade de São Paulo, Institute of Orthopedics and Traumatology, Arthroplasty Service, Brazil. omarfmiguel@gmail.com

ABSTRACT

Objective: To compare the existence of radiographic abnormalities in two groups of patients, those with and without hip pain.

Methods: A total 222 patients were evaluated between March 2007 and April 2009; 122 complained of groin pain, and 100 had no symptoms. The individuals in both groups underwent radiographic examinations of the hip using the following views: anteroposterior, Lequesne false profile, Dunn, Dunn 45º, and Ducroquet.

Results: A total of 1110 radiographs were evaluated. Female patients were prevalent in both groups (52% symptomatic, 58% asymptomatic). There were statistically significant differences between the groups in age (p<0.0001), weight (p = 0.002) and BMI (p = 0.006). The positive findings in the group with groin pain consisted of the presence of a bump on the femoral head in the anteroposterior view (p<0.0001) or in the Dunn 45º view (p = 0.008). The difference in the a angle in the anteroposterior, Dunn, Dunn 45º, and Ducroquet views for all of the cases studied was p,0.0001. The joint space measurement differed significantly between groups in the Lequesne view (p = 0.007). The Lequesne anteversion angle (ρ) and the femoral offset measurement also differed significantly (p = 0.005 and p = 0.0001, respectively).

Conclusions: We conclude that the best views for diagnosing a femoroacetabular impingement are the anteroposterior pelvic orthostatic, the Dunn 45º, and the Ducroquet views. The following findings correlated with hip pain: a decrease in the femoral offset, an increase in the α angle, an increase in the Lequesne ρ angle, a decrease in the CE angle of Wiberg, a thinner articular space and the presence of a bump on the femoral head-neck transition.

Show MeSH
Related in: MedlinePlus