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Bildgebung des Hüftgelenks beim femoroazetabulären Impingement

Imaging of the hip joint in femoroacetabular impingement

  • Leitthema
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Arthroskopie Aims and scope

Zusammenfassung

Für das femoroazetabuläre Impingement (FAI) ist charakteristisch, dass es durch Veränderungen der ossären Morphologie des Hüftgelenks zu einer typischen Konstellation von Labrum- und Knorpelverletzungen kommt, die im Verlauf zu einer Koxarthrose in einem relativ jungen Patientenkollektiv führen kann. Da es sich aber primär um ein klinisches Syndrom handelt, kann die Diagnose eines FAI nur zuverlässig gestellt werden, wenn die Morphometrie des Hüftgelenks sowie die Knorpel- und Labrumschäden in Zusammenschau mit dem klinischen Befund analysiert werden. Die Analyse der ossären Morphologie des Hüftgelenks erfolgt anhand der radiologischen Bildgebung. Die bildgebenden Kriterien und die möglichen Mess- und Analyseverfahren werden in diesem Beitrag zusammengefasst, aber auch deren Anwendung kritisch diskutiert, da die Verfahren Limitationen aufweisen und einige Veränderungen in der asymptomatischen Bevölkerung so häufig sind, dass der kausale Zusammenhang relativiert werden muss. Bezüglich der Diagnostik von Labrum- und Knorpelverletzungen sollen im Folgenden die aktuellen Standards vorgestellt werden.

Abstract

Femoroacetabular impingement is characterized by changes in the osseous morphology of the hip joint leading to a typical constellation of labral and cartilaginous injuries, which may lead to osteoarthritis in a relatively young patient population. As femoroacetabular impingement is primarily a clinical syndrome, the diagnosis can only be reliably established if the morphometric changes of the hip joint and the cartilaginous and labral injuries are analyzed in combination with the clinical symptoms. Analysis of the osseous morphology of the hip joint is based on radiological imaging. The imaging criteria and the possible qualitative findings and methods of measurement are summarized in this article. The application of the methods of measurement is critically discussed because the procedures have limitations and some changes in the asymptomatic population are so common that the causal relationship must be put into perspective. Current standards in the diagnostics of labral and cartilaginous injuries are presented.

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  1. Abteilung für Radiologie und Neuroradiologie, Alfried Krupp Krankenhaus, Alfried-Krupp-Straße 21, 45131, Essen, Deutschland

    Simone Waldt

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  1. Simone Waldt
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Correspondence to Simone Waldt.

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S. Waldt gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von der Autorin durchgeführten Studien an Menschen oder Tieren.

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Waldt, S. Bildgebung des Hüftgelenks beim femoroazetabulären Impingement. Arthroskopie 32, 86–94 (2019). https://doi.org/10.1007/s00142-018-0254-2

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  • DOI: https://doi.org/10.1007/s00142-018-0254-2

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