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Herniation pits as a radiographic indicator of pincer-type femoroacetabular impingement in symptomatic patients

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The role of herniation pits as a radiographic indicator is still debated. This case–control study was to determine (1) the prevalence and sizes of herniation pits and (2) the relationship between herniation pits and femoral and acetabular bony morphology consistent with femoroacetabular impingement.

Methods

This comparative study was performed on 151 patients (151 hips; median patient age 46 years; range 16–73 years) with mechanical symptoms, who underwent multi-detector computed tomography (MDCT) arthrography (the symptomatic group), and an age-, gender-, site (left or right)-, and time (at diagnosis)-matched group of control patients that underwent multi-detector computed tomography due to an ureter stone (the asymptomatic group). Two orthopaedic surgeons reviewed images to evaluate the prevalence, sizes of herniation pits, and relationship with morphological abnormality.

Results

The prevalences of herniation pits in symptomatic and asymptomatic groups were 23.8 % (36/151) and 3.3 % (5/151), respectively (OR 9.14, 95 % CI 3.47–24.30; p < 0.001). Herniation pits were found to be significantly associated with pincer-type abnormality (p = 0.034), especially central acetabular retroversion (p < 0.001).

Conclusions

This study shows that the prevalence of herniation pits is higher in symptomatic patients with femoroacetabular impingement, and herniation pits are associated with central acetabular retroversion. Furthermore, herniation pits were also found to be a useful predictor of pincer-type femoroacetabular impingement.

Level of evidence

III.

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Conflict of interest

The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, centre, clinical practice, or other charitable or non-profit organization with which the authors, or a member of their immediate families, are affiliated or associated.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Gyeonggi-do, South Korea

    Hyung-Min Ji

  2. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-ku, Seoul, 156-755, South Korea

    Ji-Hoon Baek, Kyoung-Woon Kim, Ji-Woong Yoon & Yong-Chan Ha

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  1. Hyung-Min Ji
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  2. Ji-Hoon Baek
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Correspondence to Yong-Chan Ha.

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Ji, HM., Baek, JH., Kim, KW. et al. Herniation pits as a radiographic indicator of pincer-type femoroacetabular impingement in symptomatic patients. Knee Surg Sports Traumatol Arthrosc 22, 860–866 (2014). https://doi.org/10.1007/s00167-013-2777-4

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  • DOI: https://doi.org/10.1007/s00167-013-2777-4

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