title: Femoroacetabular impingement and osteoarthritis of the hip.
abstract: OBJECTIVE
  To outline the clinical presentation, physical examination findings, diagnostic criteria, and management options of femoroacetabular impingement (FAI).
  
  
  METHODS
  PubMed was searched for relevant articles regarding the pathogenesis, diagnosis, treatment, and prognosis of FAI.
  
  
  RESULTS
  In recent years, FAI has been increasingly recognized as a potential precursor and an important contributor to hip pain in the adult population and idiopathic hip osteoarthritis later in life. Femoroacetabular impingement is a collection of bony morphologic abnormalities of the hip joint that result in abnormal contact during motion. Cam-type FAI relates to a non-spherical osseous prominence of the proximal femoral neck or head-neck junction. Pincer-type FAI relates to excessive acetabular coverage over the femoral head, which can occur owing to several morphologic variants. Patients with FAI present with chronic, deep, or aching anterior groin pain most commonly in the sitting position, or during or after activity. Patients might also experience occasional sharp pains during activity. A thorough history should be taken that includes incidence of trauma and exercise frequency. A physical examination should be performed that includes a full hip, low back, and abdominal examination to assess for alternate causes of anterior groin pain. Diagnosis of FAI should be confirmed with radiography. Femoroacetabular impingement can be managed conservatively with rest, modification of activities, medications, and physiotherapy, or it can be treated surgically.
  
  
  CONCLUSIONS
  Femoroacetabular impingement is an important cause of anterior groin pain. Early recognition and intervention by the primary care provider might be critical to alleviating morbidity and preventing FAI progression.
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Charlie
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Li
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Forster
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Kopec
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Ratzlaff
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Lalji
authors.initials: L
authors.lastname: Halai
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Cibere
authors.affiliation: Dr Zhang is a family medicine resident at the University of Calgary in Alberta and an alumnus of the Faculty of Medicine at the University of British Columbia in Vancouver. Dr Li is Assistant Professor in the Department of Physical Therapy at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada in Vancouver. Dr Forster is Professor and Head of the Division of Radiology at the University of British Columbia and Regional Medical Director of Medical Imaging at Vancouver General Hospital. Dr Kopec is Professor in the School of Population and Public Health at the University of British Columbia and Senior Research Scientist at the Arthritis Research Centre of Canada. Dr Ratzlaff is a postdoctoral fellow at the Arthritis Research Centre of Canada and a research fellow at Brigham and Women's Hospital at Harvard Medical School in Boston, Mass. Dr Halai is a family medicine resident at the University of British Columbia and Research Team Coordinator at the Arthritis Research Centre of Canada. Dr Cibere is Associate Professor in the Division of Rheumatology at the University of British Columbia and Senior Research Scientist in the Arthritis Research Centre of Canada. Dr Esdaile is Professor in the Division of Rheumatology at the University of British Columbia and Scientific Director of the Arthritis Research Centre of Canada.
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
mesh_terms: D000077:Acetabulum; D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology; D057925:Femoracetabular Impingement / Q000175:diagnosis* / Q000628:therapy; D005270:Femur Head; D006119:Groin; D006621:Hip Joint; D006801:Humans; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000628:therapy; D010808:Physical Examination