Tripathy Sujit Kumar, Sen Ramesh Kumar, Goyal Tarun, Patel Sandeep
Consultant Orthopaedics Surgeon, MMHRC, Madurai, India.
Am J Orthop (Belle Mead NJ). 2013 Apr;42(4):E26-9.
Femoroacetabular impingement (FAI) is often diagnosed as a cause of hip pain in athletes. Benign tumorous conditions presenting with FAI symptoms have been described in the literature, but there is no mention of any malignant lesion causing impingement. We report the case of a femur head chondrosarcoma in a 23-year-old professional football player who presented with FAI symptoms. Magnetic resonance imaging of the hip showed a bumpy outgrowth (hyperintense T2-weighted signal) from the anteroinferior portion of the femoral head without any signal changes in the rest of the head or in the hip joint. Clinical, laboratory, and radiologic findings remained inconclusive regarding a specific diagnosis. The lesion was excised through an anterior approach to the hip. Histologic evaluation of the specimen revealed an undifferentiated chondrosarcoma. Six months after surgery, the patient, completely free of pain and impingement symptoms, resumed his sports activity. At 3-year follow-up, there was no limitation in activity, and there was no evidence of tumor recurrence. Although rare, bony malignant conditions of the hip can present with FAI symptoms and a complete radiologic evaluation is warranted prior to any surgical intervention.
股骨髋臼撞击症(FAI)常被诊断为运动员髋部疼痛的病因。文献中已描述过出现FAI症状的良性肿瘤性疾病,但未提及任何导致撞击的恶性病变。我们报告一例23岁职业足球运动员股骨头软骨肉瘤病例,该患者表现出FAI症状。髋部磁共振成像显示股骨头前下部有一个凸起的肿物(T2加权像高信号),股骨头其余部分及髋关节无任何信号改变。临床、实验室及影像学检查结果对于明确诊断仍无定论。通过髋关节前路入路切除病变。标本的组织学评估显示为未分化软骨肉瘤。术后6个月,患者完全无痛且无撞击症状,恢复了体育活动。在3年随访时,活动无受限,且无肿瘤复发迹象。尽管罕见,但髋部的骨恶性疾病可表现为FAI症状,在任何手术干预前均需进行全面的影像学评估。