Association of clinical and radiographic signs of femoroacetabular impingement in the general population.
BACKGROUND
The relationships between the clinical and radiographic signs of femoroacetabular impingement (FAI) are unknown. The purpose of this study was to assess the relationship between hip pain, a positive anterior impingement sign (AIS), and radiographic signs of FAI in a general Japanese population.


METHODS
A total of 616 individuals participated in this study. Hip pain was assessed using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) pain category score and the AIS was used as a provocation test. Participants were divided into a positive AIS group (at least one positive hip) and a negative AIS group. Radiographs were assessed for the cross-over sign (COS), ischial spine sign (ISS), posterior wall sign (PWS), and pistol grip deformity (PGD). Then, the relationships between the clinical and radiographic signs of FAI were evaluated.


RESULTS
JHEQ pain scores did not differ between men and women. Seven men (3.4%) and 29 women (7.1%) had a least one hip with a positive AIS. The mean JHEQ pain scores were 22.9 ± 7.2 for the positive and 27.3 ± 2.2 for the negative AIS group (P < 0.01). The prevalences of COS, ISS, PWS, and PGD were 8.9%, 17.2%, 21.8%, and 1.9%, respectively. There were no significant associations between degree of hip pain, AIS, and each radiographic finding.


CONCLUSIONS
Radiographic signs of FAI were not associated with the degree of hip pain or a positive AIS, which suggests that radiographic findings may not be important in the clinical diagnosis of FAI.
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan. Electronic address: ryoooota@hirosaki-u.ac.jp.
Ryota
R
Yamauchi
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan.
Ryo
R
Inoue
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan; Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan.
Daisuke
D
Chiba
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan.
Yuji
Y
Yamamoto
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan.
Yoshifumi
Y
Harada
Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan.
Ippei
I
Takahashi
Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan.
Shigeyuki
S
Nakaji
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Japan.
Yasuyuki
Y
Ishibashi
D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010808:Physical Examination / Q000379:methods*; D011859:Radiography / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires