title: Real time visualization of femoroacetabular impingement and subluxation using 320-slice computed tomography.
abstract: We visualized extreme ranges of motion of the hip and located femoroacetabular impingement (FAI) and subluxations using 4dimensional (D) volume computed tomography (CT). In dynamic 4D CT, 30 patients with hip pain (>3 months) and positive clinical and radiological signs of impingement were prospectively analyzed. The investigations were performed in flexion, abduction, and external rotation. The accuracy of the CT visualization of FAI was compared with the intraoperative findings during surgical dislocation, which served as the gold standard. Compared to the intraoperative visualization of FAI, the dynamic CT images showed a high degree of accuracy. 4D CT is a suitable method to dynamically visualize the functional consequences of anatomical FAI pathologies. The location of impingement can be accurately determined, and when combined with information about possible labral tears and chondral damage supplied by magnetic resonance arthrography, allows the surgeon to select the optimal surgical access and plan the required operation for minimal invasiveness.
authors.affiliation: Orthopedic Department, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin, Berlin, Germany. georgi.wassilew@charite.de
authors.forename: Georgi I
authors.initials: GI
authors.lastname: Wassilew
authors.forename: Viktor
authors.initials: V
authors.lastname: Janz
authors.forename: Markus O
authors.initials: MO
authors.lastname: Heller
authors.forename: Stephan
authors.initials: S
authors.lastname: Tohtz
authors.forename: Patrik
authors.initials: P
authors.lastname: Rogalla
authors.forename: Patrick
authors.initials: P
authors.lastname: Hein
authors.forename: Carsten
authors.initials: C
authors.lastname: Perka
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging; D000328:Adult; D001175:Arthrography; D005260:Female; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging*; D056973:Four-Dimensional Computed Tomography; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed