What is Hip Impingement?

Types of FAI

 

There are three types of FAI:

• Pincer: When extra bone extends out over the normal rim of the acetabulum (part of the large pelvis bone), this can crush the labrum.
• Cam: When the femoral head is not round, and therefore cannot rotate smoothly within the ball-and-socket joint. A bump forms on the edge of the head that grinds up against cartilage inside the acetabulum.
• Combined: When both pincer and cam impingements are present.

 

Causes and Symptoms

 

In general, pincer and cam impingements are considered the two most common causes of FAI. Other conditions that may cause hip impingement include:

• Legg-Calve-Perthes disease: When the ball of the hip joint doesn’t get enough blood and bone dies.
• Slipped capital femoral epiphysis: When the ball separates from the thigh bone at the upper growing end, typically in adolescents, and more common in obese children.
• Coxa vara: An unusual condition where the thigh bone and ball don’t grow at the same place at a young age. It leads to deformity of the hip joint.

 

Symptoms of FAI include:

• Pain
• Stiffness
• Limping

 

Pain is often be in the groin area, or can sometimes be toward the outside of the hip. In some cases, turning, twisting or squatting can cause sharp, stabbing pain. In others, pain is just a dull ache.

 

Diagnosis

 

During your appointment, you’ll receive a general health examination and be asked about your symptoms. Your doctor may also perform the following tests:

• Impingement test: When your doctor brings you knee up toward your chest and rotates it inward toward your opposite shoulder. If this causes hip pain, the test is positive for impingement.
• Imaging tests: Tests like X-rays, CT scans and MRIs may be used to detect FAI. Your doctor may also inject a numbing anesthetic into the hip joint as a test—if it provides temporary relief, it confirms that FAI is present.

 

Treatment

 

Treatment for FAI varies between cases. When symptoms first occur, it can be helpful to try and identify cause of the pain—in some cases, you’ll be able to rest and avoid trigger activities, and pain may settle. Over-the-counter pain medications or anti-inflammatory meds may help also.

If you’re forced to see a doctor about your symptoms, treatment options could include:

• Nonsurgical: Use of anti-inflammatory medications, physical therapy and basic changes in your daily routine and activities.
• Surgery: Often arthroscopic surgery, which is done with small incisions and thin instruments to allow the surgeon to view the inside of the hip with a small camera. The doctor can repair and clean out damage to the labrum and articular cartilage, and can correct FAI by trimming the acetabulum and shaving down the bump on the femoral head. In more severe cases, an open operation with a larger incision may be needed.

 

If you’re dealing with pain in the hip, speak to your doctor about a treatment plan.

 

I treat people of all ages in my practice—kids, athletes, adults and retirees––and enjoy being able to understand people’s unique situations to help them recover.

 

Sources:

 

“Hip Impingement.” WebMD. http://www.webmd.com/pain-management/hip-impingement-causes-treatments#1

“Femoroacetabular Impingement.” American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00571