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Evidence for the Utility of Imaging of FAI

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Diagnosis and Management of Femoroacetabular Impingement

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Abstract

Femoroacetabular impingement (FAI) remains predominantly a radiographic diagnosis in symptomatic patients, which justifies the need for imaging in order to appropriately assess the severity and location of lesions associated with FAI. There are four (4) essential plain radiographic views to order: AP pelvic, Dunn lateral, frog-leg lateral, and false-profile views. The essential radiograph for the diagnosis of pincer-type FAI is the AP pelvis on which the center-edge angle and crossover sign can be assessed. Both these parameters have exhibited moderate intra- and interobserver reliability, as well as acceptable sensitivity and specificity. The Dunn lateral view is helpful for the diagnosis of cam-type FAI, on which the alpha angle can be assessed. This parameter has demonstrated good intra- and interobserver reliability, as well as good sensitivity and specificity. Computed tomography (CT) (especially 3D reconstructions) is very helpful in further defining bony morphology around the hip. It better characterizes and confirms FAI subtypes, which in turn is crucial in surgical planning. Magnetic resonance imaging (MRI) (with or without arthrography, MRA) is a useful adjunct to plain radiographs and CT in assessing the sequelae of FAI, specifically edema patterns, cartilage, and labral lesions.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Toronto Orthopaedic Sports Medicine, Toronto, ON, Canada

    Danny Arora MD, FRCS(C) & Daniel Burke Whelan MD, MSc, FRCS(C)

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  1. Danny Arora MD, FRCS(C)
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  2. Daniel Burke Whelan MD, MSc, FRCS(C)
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Correspondence to Daniel Burke Whelan MD, MSc, FRCS(C) .

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Editors and Affiliations

  1. McMaster University, Hamilton, Ontario, Canada

    Olufemi R. Ayeni

  2. Hosp, Academy University of Gothenburg, Dept. of Orthopaedics, Sahlgrenska Univ Hosp, Academy University of Gothenburg, Gothenburg, Sweden

    Jón Karlsson

  3. Steadman Clinic, Ste 1000, Steadman Philippon Research Inst Steadman Clinic, Ste 1000, Vail, Colorado, USA

    Marc J Philippon

  4. Stanford University Dept of Orthopaedic Surg, M/C 6342, Redwood City, California, USA

    Marc R. Safran

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Arora, D., Whelan, D.B. (2017). Evidence for the Utility of Imaging of FAI. In: Ayeni, O., Karlsson, J., Philippon, M., Safran, M. (eds) Diagnosis and Management of Femoroacetabular Impingement. Springer, Cham. https://doi.org/10.1007/978-3-319-32000-7_4

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  • DOI: https://doi.org/10.1007/978-3-319-32000-7_4

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