title: Hip morphology in elite golfers: asymmetry between lead and trail hips.
abstract: OBJECTIVE
  During a golf swing, the lead hip (left hip in a right-handed player) rotates rapidly from external to internal rotation, while the opposite occurs in the trail hip. This study assessed the morphology and pathology of golfers' hips comparing lead and trail hips.
  
  
  METHODS
  A cohort of elite golfers were invited to undergo MRI of their hips. Hip morphology was evaluated by measuring acetabular depth (pincer shape=negative measure), femoral neck antetorsion (retrotorsion=negative measure) and α angles (cam morphology defined as α angle >55° anteriorly) around the axis of the femoral neck. Consultant musculoskeletal radiologists determined the presence of intra-articular pathology.
  
  
  RESULTS
  55 players (mean age 28 years, 52 left hip lead) underwent MRI. No player had pincer morphology, 2 (3.6%) had femoral retrotorsion and 9 (16%) had cam morphology. 7 trail hips and 2 lead hips had cam morphology (p=0.026). Lead hip femoral neck antetorsion was 16.7° compared with 13.0° in the trail hip (p<0.001). The α angles around the femoral neck were significantly lower in the lead compared with trail hips (p<0.001), with the greatest difference noted in the anterosuperior portion of the head neck junction; 53° vs 58° (p<0.001) and 43° vs 47° (p<0.001). 37% of trail and 16% of lead hips (p=0.038) had labral tears.
  
  
  CONCLUSIONS
  Golfers' lead and trail hips have different morphology. This is the first time side-to-side asymmetry of cam prevalence has been reported. The trail hip exhibited a higher prevalence of labral tears.
authors.affiliation: Warwick Medical School, Warwick, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Dickenson
authors.affiliation: Leeds Musculoskeletal Biomedical Imaging Unit, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: O'Connor
authors.affiliation: Leeds Musculoskeletal Biomedical Imaging Unit, Leeds Teaching Hospitals, Leeds, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Robinson
authors.affiliation: Radiology Department, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Campbell
authors.affiliation: Warwick Medical School, Warwick, UK.
authors.forename: Imran
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Warwick Medical School, Warwick, UK.
authors.forename: Miguel
authors.initials: M
authors.lastname: Fernandez
authors.affiliation: European Tour Performance Institute, European Tour, Virginia Water, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Hawkes
authors.affiliation: Department of Clinical Imaging, Warwick Medical School, Warwick, UK.
authors.forename: Hutchinson
authors.initials: H
authors.lastname: Charles
authors.affiliation: Warwick Medical School, Warwick, UK.
authors.forename: Damian
authors.initials: D
authors.lastname: Griffin
mesh_terms: D000077:Acetabulum / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology; D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D003430:Cross-Sectional Studies; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005272:Femur Neck / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology; D006055:Golf / Q000502:physiology*; D006621:Hip Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation
keywords: Golf; Hip