Ibrahim Heba, Raffat Muhammad Ali, Nau Thomas
Radio-diagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Radiology department, King's College Hospital London, Dubai, UAE.
Curr Med Imaging. 2023 Mar 6. doi: 10.2174/1573405619666230306095522.
Imaging studies play a crucial role in diagnosing femoroacetabular impingement (FAI), including plain radiography and Magnetic Resonance Imaging (MRI). FAI is a combined pathology of bony abnormality, labral and labrocartilagenous erosions. Surgical treatment for such cases has become more established and preoperative imaging is the roadmap that includes the assessment of labrum and articular cartilage.
During a period of 2 years, thirty-seven patients with a clinical diagnosis of FAI were retrospectively enrolled in this study, including 17 men and 20 women, aged 27-62 years. There were 22 right hips and 15 left hips. MRI was done for all patients to identify bony details, labral and chondral abnormalities and to exclude coexisting disorders. The imaging findings were compared with the arthroscopic data.
15 patients had Pincer FAI, 11 patients had CAM, and 11 patients had combined Cam/Pincer FAI. Labral tear was detected in 100 % of patients, 97 % had an anterosuperior labral tear. 82 % of patients had partial thickness cartilage lesions and 8 % had full thickness cartilage lesions. MRI had a sensitivity of 100 % compared to hip arthroscopy in detecting labral tear, 60 % in detecting cartilage erosion.
Conventional hip MRI detects bony changes in FAI, type of impingement and associated labral tear and cartilage erosions in comparison to the hip arthroscopy.
影像学检查在诊断股骨髋臼撞击症(FAI)中起着至关重要的作用,包括X线平片和磁共振成像(MRI)。FAI是一种由骨异常、盂唇及盂唇软骨侵蚀组成的复合病变。此类病例的外科治疗已更为成熟,术前影像学检查是包含盂唇和关节软骨评估的路线图。
在2年期间,本研究回顾性纳入了37例临床诊断为FAI的患者,包括17名男性和20名女性,年龄在27至62岁之间。右髋22例,左髋15例。对所有患者均进行了MRI检查,以确定骨细节、盂唇和软骨异常,并排除并存疾病。将影像学检查结果与关节镜检查数据进行比较。
15例患者为钳夹型FAI,11例为凸轮型,11例为凸轮/钳夹混合型FAI。100%的患者检测到盂唇撕裂,其中97%为前上盂唇撕裂。82%的患者有软骨部分厚度损伤,8%有软骨全层损伤。与髋关节镜检查相比,MRI检测盂唇撕裂的敏感度为100%,检测软骨侵蚀的敏感度为60%。
与髋关节镜检查相比,传统的髋关节MRI可检测FAI的骨质改变、撞击类型以及相关的盂唇撕裂和软骨侵蚀。