Skip to main content
SpringerLink
Log in

Bone Scintigraphy in Femoroacetabular Impingement: A Preliminary Report

  • Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Femoroacetabular impingement (FAI) has recently been recognized as a cause of hip pain, labral tears, and cartilage damage in young adults. We determined the sensitivity and specificity of bone scans in diagnosing FAI and describe its findings on nuclear imaging. We prospectively followed 25 patients with hip pain (four bilateral) of greater than 6 months’ duration and a positive impingement sign (IS). All patients had plain radiographs and a three-phase bone scan followed by single-photon emission computed topographic (SPECT) images of both hips. We presumed patients had FAI if they had all three of the following findings: hip pain, positive IS, and diagnostic radiographs. Forty-six of the 50 hips had bony abnormalities on radiographs and 26 hips were diagnosed with FAI according to our criteria. Twenty-two of these 26 hips showed an increased uptake on SPECT representing true-positives. There were four false-positives, nine false-negatives, and 15 true-negatives. Sensitivity of bone SPECT was 84.7%, specificity 62.5%, positive predictive value 71%, and negative predictive value 78.9%. Focal uptake was localized to the superolateral acetabular rim and/or anterolateral femoral head-neck junction consistent with the reported intra-articular cartilage hip damage seen in FAI.

Level of Evidence: Level II, prospective study. See the Guidelines for Authors for a complete description of levels of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1A–B
Fig. 2A–D
Fig. 3A–D

Similar content being viewed by others

References

  1. Beaule PE, Harvey N, Zaragoza EJ, LeDuff M, Dorey FJ. The femoral head/neck offset and hip resurfacing. J Bone Joint Surg Br. 2007;89:9–15.

    Article  PubMed  CAS  Google Scholar 

  2. Beaule PE, LeDuff MJ, Zaragoza EJ. Quality of life outcome of femoral head/neck offset correction for femoroacetabular impingement. J Bone Joint Surg Am. 2007;89:773–779.

    Article  PubMed  Google Scholar 

  3. Beaule PE, Schmalzried TP, Campbell PA, Dorey F, Amstutz HC. Duration of symptoms and outcome of hemiresurfacing for hip osteonecrosis. Clin Orthop Relat Res. 2001;385:104–117.

    Article  PubMed  Google Scholar 

  4. Beaule PE, Zaragoza EJ, Copelan N. Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. A report of four cases. J Bone Joint Surg Am. 2004;86:2294–2298.

    PubMed  Google Scholar 

  5. Beaule PE, Zaragoza EJ, Motamedic K, Copelan N, Dorey J. Three-dimensional computed tomography of the hip in the assessment of femoro-acetabular impingement. J Orthop Res. 2005;23:1286–1292.

    PubMed  Google Scholar 

  6. 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;87:1012–1018.

    Article  PubMed  CAS  Google Scholar 

  7. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement. Part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.

    Article  PubMed  Google Scholar 

  8. Bruce W, Van der Wall H, Storey G, Lonegran R, Pitsis G, Paeds D, Kannagara S. Bone scintigraphy in acetabular labral tears. Clin Nucl Med. 2004;29:465–468.

    Article  PubMed  Google Scholar 

  9. Burnett SJ, Della Rocca GJ, Prather H, Curry M, Maloney WJ, Clohisy JC. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88:327–333.

    Article  Google Scholar 

  10. Byrd JW. Labral lesions: an elusive source of hip pain case reports and literature review. Arthroscopy. 1996;12:603–612.

    Article  PubMed  CAS  Google Scholar 

  11. Edwards DJ, Lomas D, Villar RN. Diagnosis of the painful hip by magnetic resonance imaging and arthroscopy. J Bone Joint Surg Br. 1995;77:374–376.

    PubMed  CAS  Google Scholar 

  12. Eijer H, Leunig M, Mahomed N, Ganz R. Cross-table lateral radiographs for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip Int. 2001;11:37–41.

    Google Scholar 

  13. Ganz R, Parvizi J, Leunig M, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.

    PubMed  Google Scholar 

  14. Ito K, Minka MA 2nd, Leunig S, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. J Bone Joint Surg Br. 2001;83:171–176.

    Article  PubMed  CAS  Google Scholar 

  15. Kim YJ, Jaramillo D, Millis MB, Gray ML, Burstein D. Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage. J Bone Joint Surg Am. 2003;85:1987–1992.

    Article  PubMed  Google Scholar 

  16. Leunig M, Werlen S, Ungersbock A, Ito K, Ganz R. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Br. 1997;79:230–234.

    Article  PubMed  CAS  Google Scholar 

  17. Mankin HJ. Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med. 1992;326:1473–1479.

    PubMed  CAS  Google Scholar 

  18. May O, Matar WY, Beaule PE. Treatment of failed arthroscopic acetabular labral débridement by femoral chondro-osteoplasty. A case series of five patients. J Bone Joint Surg Br. 2007;89:595–598.

    Article  PubMed  CAS  Google Scholar 

  19. Meyer DC, Beck M, Ellis T, Ganz R, Leunig M. Comparision of six radiographic projections to assess femoral head/asphericity. Clin Orthop Relat Res. 2006;445:181–185.

    PubMed  Google Scholar 

  20. Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77:985–989.

    PubMed  CAS  Google Scholar 

  21. Murphy SB, Tannast M, Kim Y-J, Buly RL, Millis MB. Débridement of the adult hip for femoroacetabular impingement. Indications and preliminary clinical results. Clin Orthop Relat Res. 2004;429:178–181.

    Article  PubMed  Google Scholar 

  22. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–560.

    Article  PubMed  CAS  Google Scholar 

  23. Peelle MW, Della Rocca GJ, Maloney WJ, Curry MC, Clohisy JC. Acetabular and femoral radiographic abnormalities associated with labral tears. Clin Orthop Relat Res. 2005;441:327–333.

    Article  PubMed  Google Scholar 

  24. Peters CL, Erickson JA. Treatment of femoro-acetabular impingement with surgical dislocation and débridement in young adults. J Bone Joint Surg Am. 2006;88:1735–1741.

    Article  PubMed  Google Scholar 

  25. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.

    Article  PubMed  CAS  Google Scholar 

  26. Ryu JS, Kim JS, Moon DH, Kim SM, Shin MJ, Chang JS, Park SK, Han DJ, Lee HK. Bone SPECT is more sensitive than MRI in the detection of early osteonecrosis of the femoral head after renal transplantation. J Nucl Med. 2002;43:1006–1011.

    PubMed  Google Scholar 

  27. Sarikaya I, Sarikaya A, Holder LE. The role of single photon emission computed tomography in bone imaging. Semin Nucl Med. 2001;31:3–16.

    Article  PubMed  CAS  Google Scholar 

  28. Schmid MR, Notzli HP, Zanetti M, Wyss TF, Hodler J. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology. 2003;226:382–386.

    Article  PubMed  Google Scholar 

  29. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am. 2003;85:278–286.

    PubMed  Google Scholar 

  30. Tonnis D. Normal values of the hip of the hip joint for the evaluation of x-rays in children and adults. Clin Orthop Relat Res. 1976;119:39–47.

    PubMed  Google Scholar 

  31. Wenger DE, Kendall KR, Miner M, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426:145–150.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital–General Campus, Critical Care Wing 1646, 501 Smyth Road, Ottawa, ON, Canada, K1H 8L6

    Wadih Y. Matar MD, MSc, FRCSC & Paul E. Beaulé MD, FRCSC

  2. Université de Lille 2, Lille, Nord, France

    Olivier May MD, MSc

  3. Division of Nuclear Medicine, University of Ottawa, Ottawa, ON, Canada

    François Raymond MD, FRCSC

Authors
  1. Wadih Y. Matar MD, MSc, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Olivier May MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. François Raymond MD, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul E. Beaulé MD, FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul E. Beaulé MD, FRCSC.

Additional information

One or more of the authors (OM) has received funding from Societé Française de Chirurgie Orthopédique et Traumatologique.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

About this article

Cite this article

Matar, W.Y., May, O., Raymond, F. et al. Bone Scintigraphy in Femoroacetabular Impingement: A Preliminary Report. Clin Orthop Relat Res 467, 676–681 (2009). https://doi.org/10.1007/s11999-008-0662-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-008-0662-0

Keywords

Search

Navigation