Abstract
Young adult patients presenting with hip pain can pose a challenging diagnostic dilemma for the inexperienced physician. A thorough history and physical examination followed by the appropriate imaging can often lead to the right diagnosis. In this chapter, distinguishing between two of the most common hip pathologies affecting the young adult, namely, hip dysplasia and femoroacetabular impingement (FAI), will be discussed. Diagnosing these two types of mechanical hip disorders can be at times challenging since they can coexist in the same patient [1–3] (Fig. 19.1).
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References
Klaue K, Durnin CW, Ganz R (1991) The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Joint Surg Br 733:423–429
Clohisy JC, Beaule PE, O’Malley A, Safran MR, Schoenecker P (2008) AOA symposium. Hip disease in the young adult: current concepts of etiology and surgical treatment. J Bone Joint Surg Am 9010:2267–2281
Siebenrock KA, Schoeniger R, Ganz R (2003) Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am 85-A2:278–286
Guille JT, Pizzutillo PD, MacEwen GD (2000) Development dysplasia of the hip from birth to six months. J Am Acad Orthop Surg 84:232–242
Dezateux C, Rosendahl K (2007) Developmental dysplasia of the hip. Lancet 3699572:1541–1552
Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120
Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res 418:61–66
Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res 213:20–33
Sierra RJ, Trousdale RT, Ganz R, Leunig M (2008) Hip disease in the young, active patient: evaluation and nonarthroplasty surgical options. J Am Acad Orthop Surg 1612:689–703
Peelle MW, la Rocca GJ, Maloney WJ, Curry MC, Clohisy JC (2005) Acetabular and femoral radiographic abnormalities associated with labral tears. Clin Orthop Relat Res 441:327–333
Wenger DE, Kendell KR, Miner MR, Trousdale RT (2004) Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res 426:145–150
Beck M, Kalhor M, Leunig M, Ganz R (2005) 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 877:1012–1018
Beaule PE, Le Duff MJ, Zaragoza E (2007) Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am 894:773–779
Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res 445:181–185
Lequesne M, de Seze S (1961) False profile of the pelvis. A new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies. Rev Rhum Mal Osteoartic 28:643–652
Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 844:556–560
Leunig M, Werlen S, Ungersbock A, Ito K, Ganz R (1997) Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Br 792:230–234
Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R (2004) Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res 418:74–80
Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE (2005) Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 2362:588–592
Siebenrock KA, Kalbermatten DF, Ganz R (2003) Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res 407:241–248
Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand 58(Suppl 83):7
Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 611:15–23
Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 785:683–692
Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 812:281–288
Kalberer F, Sierra RJ, Madan SS, Ganz R, Leunig M (2008) Ischial spine projection into the pelvis: a new sign for acetabular retroversion. Clin Orthop Relat Res 4663:677–683
Sotelo-Garza A, Charnley J (1978) The results of Charnley arthroplasty of hip performed for protrusio acetabuli. Clin Orthop Relat Res 132:12–18
Murray RO (1965) The aetiology of primary osteoarthritis of the hip. Br J Radiol 38455:810–824
Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand 714:370–375
Eijer H, Myers SR, Ganz R (2001) Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma 157:475–481
Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R (2005) Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 2361:237–246
Eijer H, Leunig M, Mahomed N, Ganz R (2001) Cross-table lateral radiographs for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip Int 11:37–41
Locher S, Werlen S, Leunig M, Ganz R (2002) MR-arthrography with radial sequences for visualization of early hip pathology not visible on plain radiographs. Z Orthop Ihre Grenzgeb 1401:52–57
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Matar, W.Y., Parvizi, J. (2012). Differentiating FAI from Dysplasia. In: Marín-Peña, Ó. (eds) Femoroacetabular Impingement. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-22769-1_19
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DOI: https://doi.org/10.1007/978-3-642-22769-1_19
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