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A Three-View Radiographic Approach to Femoroacetabular Impingement

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TAKE-HOME POINTS

  • FAI is a frequently unrecognized cause of hip pain in adolescents and young adults.
  • Understanding the potential sites of impingement and the specific radiographs to visualize these sites can help avoid unnecessary imaging and delayed diagnosis.
  • A simple radiographic approach consisting of a standing AP view of the pelvis, a cross-table lateral view, and a false profile view is often a sufficient screening tool.
  • While we tend to classify FAI into cam and pincer osseous bumps, alterations in hip dynamics can result in functional impingement even in the absence of the osseous bumps.
  • Advanced imaging is reserved for patients who have failed conservative management or are considering surgical intervention.


 

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ABSTRACT

Femoroacetabular impingement (FAI) is an abnormality of the hip joint that is increasingly being recognized as a cause of athletic disability and early degenerative hip disease. Despite significant advances in the knowledge of FAI, it remains a frequently unrecognized cause of hip pain in adolescents and young adults among orthopedic providers. The purpose of this article is to present a simple 3-view radiographic approach to young adults with hip pain. The radiographs include a standing anteroposterior view of the pelvis, a cross-table lateral view, and a false profile view. Good quality radiographs showing the common sites of potential impingement combined with a basic understanding of certain radiographic parameters may allow faster diagnosis, eliminate unnecessary studies, and allow earlier referral and management.

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