Hip Impingement

Question 1

What is Femoroacetabular Impingement Syndrome (FAI)?

Answer 1

A condition where abnormal contact between the femoral neck and the acetabular rim during movement (especially flexion, adduction, and internal rotation) causes pain and joint damage

Question 2

What are the three types of FAI?

Answer 2

1. CAM type
2. Pincer type
3. Mixed type

Question 3

What is the CAM type?

Answer 3

Abnormal femoral head shape
= common in young athletic males

Question 4

What is the pincer type?

Answer 4

Overcoverage of the acetabulum
= common in females

Question 5

What is the mixed type?

Answer 5

Features of both CAM and pincer types

Question 6

What type of FAI is associated with prior SUFE?

Answer 6

CAM type impingement

Question 7

What are the main symptoms of FAI?

Answer 7

1. Activity-related groin pain
   = especially with flexion and rotation
2. Difficulty sitting for long periods

Question 8

What is a “C-sign” and what does it indicate?

Answer 8

It’s when a patient cups their hand in a C-shape over the lateral hip to localise deep pain

= t’s a classic sign of intra-articular hip pathology like FAI

Question 9

What physical test is used to provoke pain in FAI?

Answer 9

FADIR test
1. Flexion
2. Adduction
3. Internal Rotation of the hip reproduces pain

Question 10

When is surgery indicated in FAI?

Answer 10

(1) Persistent symptoms despite conservative management

(2) Arthroscopic or open surgery may be used to reshape the femoral head (CAM) or trim the acetabular rim (Pincer)

(3) Total hip replacement may be needed in older patients with secondary OA

Question 10

What is the best imaging modality to detect labral damage or bone oedema in FAI?

Answer 10

MRI

Question 11

What is the consequence of untreated FAI?

Answer 11

Progressive damage to the labrum and cartilage, leading to early-onset osteoarthritis