Phillips Elizabeth, Khoury Viviane, Wilmot Andrew, Kelly John D
Orthopedics. 2016 May 1;39(3):e417-22. doi: 10.3928/01477447-20160404-03. Epub 2016 Apr 12.
A mechanistic link has been suggested between cam-type femoroacetabular impingement and increased stress on the symphysis pubis. This retrospective study was conducted to determine whether there is an increased prevalence of osteitis pubis, as evidenced by imaging, in patients with femoroacetabular impingement compared with age-matched control subjects. Search of a radiologic database of a large academic health institution for all patients with cam-type femoroacetabular impingement diagnosed by magnetic resonance imaging or magnetic resonance arthrogram between January 2000 and October 2013 identified 46 cases. Two radiologists reviewed these cases independently and confirmed the presence of femoroacetabular impingement based on alpha angle and other characteristics of cam morphology. The imaging studies were further evaluated for characteristics of osteitis pubis, with severity graded from minimal to severe on a 4-point Likert scale. A control group composed of age-matched subjects without diagnosed femoroacetabular impingement was also evaluated for osteitis pubis. A statistically significant increase in the prevalence of osteitis pubis was found in patients with femoroacetabular impingement compared with age-matched control subjects, with a prevalence of 43.48% in the femoroacetabular impingement group compared with 12.77% in the control group (P=.0012). On the 4-point Likert scale, the average severity of osteitis pubis in the group with femoroacetabular impingement was 1.5 (minimal to mild) compared with 0.53 (no osteitis pubis to minimal findings) in the control population. This significant increase in osteitis pubis in patients with femoroacetabular impingement supports the clinical link between these 2 processes. [Orthopedics. 2016; 39(3):e417-e422.].
凸轮型股骨髋臼撞击症与耻骨联合应力增加之间存在一种机制上的联系。本回顾性研究旨在确定与年龄匹配的对照受试者相比，股骨髋臼撞击症患者中耻骨炎的患病率是否通过影像学表现有所增加。检索一家大型学术健康机构的放射学数据库，以查找2000年1月至2013年10月期间通过磁共振成像或磁共振关节造影诊断为凸轮型股骨髋臼撞击症的所有患者，共识别出46例。两名放射科医生独立审查这些病例，并根据α角和凸轮形态的其他特征确认存在股骨髋臼撞击症。对影像学研究进一步评估耻骨炎的特征，严重程度按4级李克特量表从轻度到重度分级。还对由未诊断出股骨髋臼撞击症的年龄匹配受试者组成的对照组进行耻骨炎评估。与年龄匹配的对照受试者相比，发现股骨髋臼撞击症患者耻骨炎的患病率有统计学意义的增加，股骨髋臼撞击症组的患病率为43.48%，而对照组为12.77%（P = 0.0012）。在4级李克特量表上，股骨髋臼撞击症组耻骨炎的平均严重程度为1.5（轻度至中度），而对照人群为0.53（无耻骨炎至轻微表现）。股骨髋臼撞击症患者耻骨炎的显著增加支持了这两个过程之间的临床联系。[《骨科》。2016年；39(3):e417 - e422。]
