640px-Figure_1._Basic_anatomy_of_the_hip_joint.png

This shows the anatomy of the hip, including the proximal head of the femur, acetabulum, and labrum

640px-Ballet_Don_Quijote_en_Teatro_Teresa_Carreño_2.jpg

Young dancers, especially ballerinas are at increased risk of femoroacetabular impingement.

Impingement (FAI)

What is the hip joint? And how does it get FAI?

The femoroacetabular joint, commonly known as the hip joint, is a complex joint which provides a lot of the motion necessary for everyday tasks.  Even small issues can cause noticeable symptoms. The hip is a ball and socket joint, with the ball (head of the femur) fitting into the socket (acetabulum) like “ice cream on a cone”.

 

In FAI, the ball and socket are abnormally aligned and there is increased friction between the bones. This can be caused by a variety of factors, from abnormal development during childhood to arthritis.

What does it feel like?

Increased friction at the hip joint during FAI often causes pain at the groin or outside of hip, stiffness, and limited movement. You may feel heightened pain with movements like squatting, twisting, or sitting for long periods of time.

Who is at risk?

Young athletes in sports with hip twisting and squatting movements like dancing (especially ballet), soccer, and golf more commonly experience this condition. Additionally, those who are physically active may experience this condition earlier in life than those who are not. Those with genetic conditions that cause misalignment in the hip joint like slipped capital femoral epiphysis may also be at risk of developing this condition.

How is it diagnosed?

To diagnose this condition, your physician will perform a medical history and physical exam. They may also use imaging tests or inject a local anesthetic so see if the numbing medication relieves pain in the joint.

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Knee

What are the types?

There are three types of FAI:

  • Pincer: Pincer FAI is a problem with the socket. The acetabulum has extra bone growing out of it that can damage the labrum (connective tissue that lines the joint). Pincer commonly occurs with active females in their 30s and 40s.

  • CAM: CAM is a problem with the “ball”. The femoral head is abnormally shaped, causing it to “grind” at the cartilage on the inside of the acetabulum. CAM commonly occurs in young male athletes (normally younger than 20).

  • Combined: Combined FAI occurs when an individual experiences Pincer and CAM FAI simultaneously.

How is it treated?

FAI is commonly treated with resting the injured joint by avoiding activities that cause pain and using Nonsteroidal Anti-Inflammatory Drugs like Advil and Motrin. Corticosteroid injections can offer antiinflammatory properties to help relieve pain. If more conservative methods are unsuccessful, patients can consider surgical options. In surgery, your surgeon may get rid of damaged tissue, correct the shape of the hip joint, or use arthroscopic methods.

Sources
Attribution for Images

1. Smith & Nephew. “Basic anatomy of the hip joint”. Wikimedia Commons, 2 June 2011, https://commons.wikimedia.org/wiki/File:Figure_1._Basic_anatomy_of_the_hip_joint.png.

2. Wilfredor. “Ballet Don Quijote en Teatro Teresa Carreño 2”. Wikimedia Commons, 20 August 2013, https://commons.wikimedia.org/wiki/File:Ballet_Don_Quijote_en_Teatro_Teresa_Carre%C3%B1o_2.jpg.

3. Smith & Nephew. “Figure 6. Diagram of the bony pathology of both cam and pincer impingement”. Wikimedia Commons, 2 June 2011, https://commons.wikimedia.org/wiki/File:Figure_6._Diagram_of_the_bony_pathology_of_both_cam_and_pincer_impingement..png.

4. Irib. “Ibuprofen”. Wikimedia Commons, May 26, 2014, https://commons.wikimedia.org/wiki/File:Ibuprofen_l%C3%A9%C4%8Div%C3%A9_p%C5%99%C3%ADpravky.JPG

640px-Figure_6._Diagram_of_the_bony_pathology_of_both_cam_and_pincer_impingement..png

This diagram of the hip shows both Pincer and CAM impingement.

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NSAIDs like Aleve and Motrin like relieve pain and inflammation.