Advertisement

Skeletal Radiology

, Volume 49, Issue 1, pp 101–108 | Cite as

Regional muscle changes in adult dysfunctional hip conditions of femoroacetabular impingement and hip dysplasia

  • Majid Chalian
  • Natalie Schauwecker
  • Anthony Cai
  • Riham Dessouky
  • Nicholas Fey
  • Yin Xi
  • Avneesh ChhabraEmail author
  • Joel Wells
Scientific Article

Abstract

Objective

To analyze regional muscle CT density and bulk in femoroacetabular impingement (FAI) and hip dysplasia (HD) versus controls.

Materials and methods

Patients who obtained perioperative CT imaging for FAI and HD before surgery were retrospectively studied. Asymptomatic controls included for comparison. Two readers independently evaluated regional hip muscle [iliopsoas (IP), rectus femoris (RF), gluteus minimus (Gm), and medius (GM)] density, muscle area, and muscle circumference. Inter-observer reliability calculated using intra-class correlation coefficient (ICC).

Results

A consecutive series of 25 FAI patients, 16 HD patients, and 38 controls were recruited in the study. FAI patients had significantly greater Gm and GM circumferences as well as greater RF and IP areas on the normal side compared to the asymptomatic control group (p values 0.004, 0.032, 0.033, and 0.028, respectively). In addition, Gm and RF circumferences and RF area were significantly larger (p values 0.029, 0.036, and 0.014, respectively) in FAI patients on the affected side compared to the control group. HD patients had significantly smaller Gm and GM circumferences on the affected side than normal side measurements in FAI group (p values 0.043 and 0.003, respectively). Normal side GM circumference was also smaller in HD patients than normal side FAI hips (p value 0.02). There was no significant difference between the measurements on normal and abnormal sides in each disease group. No significant difference was found between measurements of HD compared to controls (p > 0.05). No muscle density differences were seen among different groups. There was moderate to excellent inter-reader reliability for all measurements except Gm muscle density.

Conclusions

Muscle analysis was able to quantify differences among patients with FAI, HD, and asymptomatic controls. These changes could indicate either a muscle imbalance contributing to the pathology or disuse atrophy, which may have implications for specific muscle-strengthening therapies and rehabilitation procedures in such patients.

Keywords

Femoroacetabular impingement Hip dysplasia CT Skeletal muscle Hip pain 

Notes

Compliance with ethical standards

Conflict of interest

AC receives royalties from Jaypee and Wolters. AC also serves as consultant with ICON Medical and Treace Medical Concepts Inc.

Other authors do not report any conflicts of interest.

References

  1. 1.
    Mascarenhas VV, Rego P, Dantas P, et al. Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: a systematic review. Eur J Radiol Elsevier. 2016;85(1):73–95.CrossRefGoogle Scholar
  2. 2.
    Li AE, Jawetz ST, Greditzer HG, Burge AJ, Nawabi DH, Potter HG. MRI for the preoperative evaluation of femoroacetabular impingement. Insights Imaging. 2016;7(2):187–98.CrossRefGoogle Scholar
  3. 3.
    Gala L, Clohisy JC, Beaulé PE. Hip dysplasia in the young adult. J Bone Joint Surg. 2016;98(1):63–73.CrossRefGoogle Scholar
  4. 4.
    Hipp JA, Sugano N, Millis MB, Murphy SB. Planning acetabular redirection osteotomies based on joint contact pressures. Clin Orthop Relat Res. 1999;364:134–43.CrossRefGoogle Scholar
  5. 5.
    Jacobsen S, Sonne-Holm S. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. Rheumatology. 2005;44(2):211–8.CrossRefGoogle Scholar
  6. 6.
    Guevara CJ, Pietrobon R, Carothers JT, Olson SA, Vail TP. Comprehensive morphologic evaluation of the hip in patients with symptomatic labral tear. Clin Orthop Relat Res. 2006;453:277–85.CrossRefGoogle Scholar
  7. 7.
    Clohisy JC, Beaulé PE, O’Malley A, Safran MR, Schoenecker P. AOA symposium. Hip disease in the young adult: current concepts of etiology and surgical treatment. J Bone Joint Surg Am. 2008;90(10):2267–81.CrossRefGoogle Scholar
  8. 8.
    Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012–8.CrossRefGoogle Scholar
  9. 9.
    Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 2008;466(2):264–72.CrossRefGoogle Scholar
  10. 10.
    Reisinger KW, van Vugt JLA, Tegels JJW, et al. Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Ann Surg. 2015;261(2):345–52.CrossRefGoogle Scholar
  11. 11.
    Marcus RL, Addison O, Dibble LE, Foreman KB, Morrell G, Lastayo P. Intramuscular adipose tissue, sarcopenia, and mobility function in older individuals. J Aging Res. 2012;2012:629637.CrossRefGoogle Scholar
  12. 12.
    Kierkegaard S, Mechlenburg I, Lund B, Søballe K, Dalgas U. Impaired hip muscle strength in patients with femoroacetabular impingement syndrome. J Sci Med Sport. 2017;20(12):1062–7.CrossRefGoogle Scholar
  13. 13.
    Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRefGoogle Scholar
  14. 14.
    Sankar WN, Beaulé PE, Clohisy JC, et al. Labral morphologic characteristics in patients with symptomatic acetabular dysplasia. Am J Sports Med. 2015;43(9):2152–6.CrossRefGoogle Scholar
  15. 15.
    Le Bouthillier A, Rakhra KS, Belzile EL, Foster RCB, Beaulé PE. Soft tissue structures differ in patients with prearthritic hip disease. J Orthop Trauma. 2018;32(Suppl 1):S30–4.CrossRefGoogle Scholar
  16. 16.
    Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540–52.CrossRefGoogle Scholar
  17. 17.
    Greenhill BJ, Hugosson C, Jacobsson B, Ellis RD. Magnetic resonance imaging study of acetabular morphology in developmental dysplasia of the hip. J Pediatr Orthop. 1993;13(3):314–7.CrossRefGoogle Scholar
  18. 18.
    Tatara AM, Lipner JH, Das R, et al. The role of muscle loading on bone (re)modeling at the developing enthesis. Heymann D, editor. PLoS One. 2014;9(5):e97375.CrossRefGoogle Scholar
  19. 19.
    Ellman R, Spatz J, Cloutier A, Palme R, Christiansen BA, Bouxsein ML. Partial reductions in mechanical loading yield proportional changes in bone density, bone architecture, and muscle mass. J Bone Miner Res. 2013;28(4):875–85.CrossRefGoogle Scholar
  20. 20.
    Ford CA, Nowlan NC, Thomopoulos S, Killian ML. Effects of imbalanced muscle loading on hip joint development and maturation. J Orthop Res. 2017;35(5):1128–36.CrossRefGoogle Scholar
  21. 21.
    Schwartz AG, Lipner JH, Pasteris JD, Genin GM, Thomopoulos S. Muscle loading is necessary for the formation of a functional tendon enthesis. Bone. 2013;55(1):44–51.CrossRefGoogle Scholar
  22. 22.
    Thomopoulos S, Kim H-M, Rothermich SY, Biederstadt C, Das R, Galatz LM. Decreased muscle loading delays maturation of the tendon enthesis during postnatal development. J Orthop Res. 2007;25(9):1154–63.CrossRefGoogle Scholar
  23. 23.
    Berg HE, Eiken O, Miklavcic L, Mekjavic IB. Hip, thigh and calf muscle atrophy and bone loss after 5-week bedrest inactivity. Eur J Appl Physiol. 2007;99(3):283–9.CrossRefGoogle Scholar
  24. 24.
    Alkner BA, Tesch PA. Knee extensor and plantar flexor muscle size and function following 90 days of bed rest with or without resistance exercise. Eur J Appl Physiol. 2004;93(3):294–305.CrossRefGoogle Scholar

Copyright information

© ISS 2019

Authors and Affiliations

  • Majid Chalian
    • 1
  • Natalie Schauwecker
    • 1
  • Anthony Cai
    • 1
  • Riham Dessouky
    • 1
  • Nicholas Fey
    • 1
  • Yin Xi
    • 1
  • Avneesh Chhabra
    • 1
    Email author
  • Joel Wells
    • 2
  1. 1.Radiology DepartmentUT Southwestern Medical CenterDallasUSA
  2. 2.Orthopedics DepartmentUT Southwestern Medical CenterDallasUSA

Personalised recommendations