FAIS - Femoral Acetabular Impingement Syndrome Flashcards
In one sentence, what is femoroacetabular impingement syndrome?
FAIS is characterized by premature contact between the femoral head and acetabulum due to irregular joint surfaces.
What is the tissue at fault in FAIS?
Osteophytes that develop on the on the femoral head or labral surface.
Which region of the hip joint is eroded first in FAIS?
Posterior and central portions are eroded by osteophytes with movement.
What is the MOI for FAIS?
Can be traumatic and/or insidious. Examples include:
i) sitting for long periods
ii) excessive loading demands on the hip
iii) abnormal joint morphology
Is FAIS a mobility or stability pathology?
Stability. Weakness of the hip musculature (flex, ABD, IR) causes increased joint loading and anterior glide of the femoral head.
What is CAM pathology of FAIS
Ossification of the femoral neck causing premature contact with the labrum. This also flattens the femoral neck junction.
What is pincer pathology of FAIS?
Ossification of the labrum that is amplified by repeat contact with femoral head. This causes overcoverage of the femoral head.
What subjective reports might be expected with FAIS?
i) catching, clunking, grinding
ii) pain in thigh, back or buttock
iii) limited ROM
iv) aggravated by acceleration, high loading and prolonged sitting.
How is FAIS diagnosed?
i) clinical findings and history
ii) diagnostic imaging
What precautions exist in suspected FAIS?
Repetitive and prolonged positions of hip flexion and internal rotation.
What outcome measures are indicated in FAIS?
i) International Hip Outcome Tool
ii) Copenhagen Hip and Groin Outcome Score
iii) Hip Outcome Score
What are 5 key objective tests to determine the presence of FAIS and their expected findings?
i) A/PROM: flexion and IR most limited, capsular end feel
ii) Hip Scour Test: symptom reproduction, limited IR
iii) FABER Distance Test: greater distance on affected side.
iv) MMTs: weak hip flexion and ABD (possibly others)
v) Ober’s: +ve for TFL tightness (compensate for weak ABDs).
What are two differential diagnoses for FAIS and how would you rule them out?
i) Adductor tendinopathy: symptoms and provocative test will be specific to only adductors.
ii) Osteoarthritis: capsular pattern of restriction, age and subjective history
When can a patient with FAIS expect to see improvement with conservative treatment?
6-8 weeks.
Is surgery indicated in FAIS? Explain.
Depending on the patient. Arthroscopic surgery is equally as effective as physical therapy.
