Imaging Hip Problems in Athletes - University of Wisconsin-Madison
Imaging Hip Problems in Athletes - University of Wisconsin-Madison Imaging Hip Problems in Athletes - University of Wisconsin-Madison
4/11/2011 Capsule injury 22 year-old football player with hip pain Ligamentum Teres • LT connects the fovea to the PI acetabular fossa • Mechanical symptoms can occur with ruptured LT; clicking/ “giving away” • ? Repair Posterior capsule T2 Fat Sat T2 Fat Sat Hip Plica FAI T1 FS http://www.edwinsu.com/hip-arthroscopy.html Femoroacetabular Impingement (FAI) • FAI results from anatomic abnormalities of the proximal femur and/or acetabulum • FAI can cause: – Labral tears – Cartilage lesions – Premature OA Mechanisms of Impingement • Cam (“femoral”FAI) – Abnormal morphology anterior femoral headneck junction – Seen in younger individuals Beall Skeletal Radiol 2005; 34:691-701. Ganz Clin Orthop 2003; 417:112-120. 6
4/11/2011 Mechanisms of Impingement • Cam (“femoral”FAI) – Abnormal morphology anterior femoral headneck junction – Seen in younger individuals • Pincer (“acetabular” FAI) – Abnormal acetabulum contacting a normal femur – More common in older women • Both types are common in athletes NORMAL CAM PINCER MIXED Philippon et al. Am J Sports Med 2007;35:1571 Clinical Presentation Cam FAI • Slow onset of groin pain after minor trauma – Intermittent – Exacerbated by athletic activities, walking • PE P.E. – Limitation of motion • Internal rotation and adduction in flexion – Positive impingement test 29 y/o man with hip pain Radiographic findings can “predispose” to cam FAI Klaue K. J Bone Joint Surg 1991;73B:423-429. Cam FAI Sag T1FS Bilateral FAI changes 20 year-old man with bilateral hip pain Cor T1FS Femoral bump Axial oblique T1FS Axial oblique T1FS 7
- Page 1 and 2: 4/11/2011 Part II: Imaging Hip Prob
- Page 3 and 4: 4/11/2011 Stress Fractures Femoral
- Page 5: 4/11/2011 Posterior Labral Tear & P
- Page 9 and 10: 4/11/2011 Iliacus Psoas Snapping Hi
- Page 11 and 12: 4/11/2011 Muscle/Tendon Injury Comp
- Page 13: 4/11/2011 Osteitis Pubis Adductor I
4/11/2011<br />
Capsule <strong>in</strong>jury<br />
22 year-old football player with hip pa<strong>in</strong><br />
Ligamentum Teres<br />
• LT connects the fovea to the PI acetabular fossa<br />
• Mechanical symptoms can occur with ruptured LT; click<strong>in</strong>g/<br />
“giv<strong>in</strong>g away”<br />
• ? Repair<br />
Posterior capsule<br />
T2 Fat Sat<br />
T2 Fat Sat<br />
<strong>Hip</strong> Plica<br />
FAI<br />
T1 FS<br />
http://www.edw<strong>in</strong>su.com/hip-arthroscopy.html<br />
Femoroacetabular Imp<strong>in</strong>gement (FAI)<br />
• FAI results from anatomic abnormalities<br />
<strong>of</strong> the proximal femur and/or<br />
acetabulum<br />
• FAI can cause:<br />
– Labral tears<br />
– Cartilage lesions<br />
– Premature OA<br />
Mechanisms <strong>of</strong> Imp<strong>in</strong>gement<br />
• Cam (“femoral”FAI)<br />
– Abnormal morphology anterior femoral headneck<br />
junction<br />
– Seen <strong>in</strong> younger <strong>in</strong>dividuals<br />
Beall Skeletal Radiol 2005; 34:691-701.<br />
Ganz Cl<strong>in</strong> Orthop 2003; 417:112-120.<br />
6
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