Femoroacetabular impingement
Make an Appointment
Talk to DoctorOverview
Femoroacetabular impingement (FAI), also known as hip impingement, is a disorder where the hip joint is abnormally shaped, which results in the femur and acetabulum bones rubbing against each other. This friction leads to limit range of motion and pain in the hip.
FAI is categorized into three:
- Cam: The femoral head cannot spin smoothly inside the acetabulum due to its irregular shape in cam impingement. The femoral head develops a bulge that grinds the cartilage in the acetabulum. Physical exercise may occasionally result in this development.
- Pincer: This kind of impingement happens when excess bone protrudes beyond the acetabulum’s natural rim. Under the acetabulum’s protruding rim, the labrum is susceptible to being crushed.
- Combined: There are both pincer and cam kinds of FAI.
Corticosteroids, nonsteroidal anti-inflammatory medications (NSAIDs), physical therapy, rest, and surgery can all be used to treat this condition. Without treatment, FAI can harm the cartilage that provides support in the hip. This harm may result in painful joint degeneration or arthritis. To restore the damage, some people require surgery.
Symptoms
There may be no symptoms in certain FAI cases. The condition may start to show symptoms as hip injury gets worse. FAI symptoms and indicators include:
- Hip pain that becomes worse with exercise or prolonged sitting
- Limping
- Stiffness
Symptoms of FAI may include pain, typically in the groin area but it can also occur on the outside of the hip. A sharp, stabbing pain could be brought on by turning, twisting, or squatting. Sometimes the discomfort is merely a dull aching.
When symptoms first start, it might be beneficial to try to pinpoint a particular action or circumstance that may have contributed to the discomfort. Patient can occasionally alter their routine, give their hip a rest, and see if the pain goes away. Ibuprofen and naproxen are examples of over-the-counter anti-inflammatory drugs that may be helpful.
Patient must see a doctor if their symptoms do not go away, for proper diagnosis, and to provide possible treatments. If left untreated it could do more damage to the hip.
Causes
FAI happens as a result of abnormal hip bone development throughout childhood. Joint pain and injury are caused by the deformity of a cam bone spur, pincer bone spur, or both. The hip joint, which connects the femur to the pelvis, is a ball-and-socket joint. The ball (top of the femur) or the socket are abnormal in FAI patients (groove in the hip bone). When moving, the abnormality creates friction that could harm the labrum and cartilage.
FAI pain may manifest in physically active people earlier than in less active ones. However, exercise typically does not result in FAI.
Risk Factors
People who are physical active have higher chances in developing FAI.
Diagnosis
To properly diagnose FAI, a number of tests will be recommended. The healthcare provider will inquire about the family history and amount of activity. Healthcare provider may request the following to support FAI diagnosis.
- Physical exam: Can determine if the hip joint is functioning properly by analyzing the range of motion, muscular strength, and walking style.
- Impingement test: The test will probably be performed by the healthcare provider during the physical assessment. Patient’s knee will be raised near to their chest and rotated inward toward the opposite shoulder. If doing so causes hip pain then impingement has been detected during the test.
- Imaging tests: To assist identifying FAI, healthcare provider will perform imaging testing.
- X-ray: can generate images of the bones in your hip that show signs of FAI and any arthritis symptoms present.
- Computed tomography (CT) scan: are more thorough than standard x-rays, enable the healthcare provider to pinpoint the precise abnormal hip shape.
- Magnetic resonance imaging (MRI): which can create detailed images of soft tissue, can help a doctor detect damage to the labrum and cartilage in the joint. The use of contrast dye during the MRI can enhance visibility of the damage.
- Local anesthetic: By injecting numbing medication into the hip joint to test if it reduces discomfort. Temporary pain reduction from the numbing medication is confirm that patient have FAI.
Treatment
Treatment for FAI varies depending on the patient and the extent of the damage. Options for FAI treatment include:
- Corticosteroids: These medications lessen hip joint swelling and inflammation. This treatment is typically given by injection.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): This kind of medication often comes in pill form and reduces inflammation. Ibuprofen and other medications can be given at prescription strength to help with pain management and inflammation.
- Physical therapy: The hip’s range of motion can be increased by certain exercises, which can also strengthen the muscles that support the joint. The injured labrum or cartilage may feel less strain as a result.
- Rest: You can reduce friction in the hip joint by decreasing certain activities. Healthcare provider may recommend changing your daily routine and avoiding activities that may cause FAI.
- Surgery: If non-surgical treatments are not providing any pain relief and still reveal that FAI has damaged the joints, healthcare provider may advise surgery, such as:
- Arthroscopic hip surgery: In this minimally invasive surgery, the surgeon fixes or eliminates damaged bone or cartilage. Thin devices and small incisions are used during arthroscopic treatments. An arthroscope, a tiny camera used by surgeons to examine inside the hip.
- Traditional hip surgery: When the damage is more serious, surgeons perform an open surgery with a wider incision to repair the damage.
