Abstract
Giriş: Femoroasetabular sıkışma (FAI) klinik ve radyolojik tanısı olan hastaların manyetik rezonans görüntüleme (MRI) ve alfa açısı ve Wiberg tarafından tanımlanan merkezi köşe açısı ile kontrol grubu ile değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Rutin kalça MRG'leri Ocak 2016 ile Mayıs 2019 arasında retrospektif olarak incelendi. Klinik ve radyolojik olarak kam, kıskaç ve karışık FAI tanısı alan hastalar kaydedildi. Yaş ve cinsiyetle eşleşen bir kontrol grubu oluşturuldu. Eksenel T1A MRI görüntülerinde alfa açısı, femur başının merkezinden femur boynuna doğru paralel çizgi ve femur başı ile ön taraftaki boyun ve merkezden çizilen çizgi arasındaki geçiş çizgisi olarak ölçüldü. femur başı. Wiberg'in merkezi köşe açısı, koronal T1A görüntüleri üzerinde femur başının merkezinden asetabuluma çekilen dikey çizgi ile asetabulumun en dıştaki noktasını birleştiren çizgi arasındaki açı olarak ölçülmüştür. Ölçümler her iki grupta istatistiksel olarak karşılaştırıldı. P <0.05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: FAI olan 28 hastanın 16'sında (18 erkek, 10 kadın) her iki kalçada sıkışma vardı ve toplam 44 kalça incelendi. Hasta grubunda 9 kam, 23 kıskaç ve 12 karışık sıkışma vakası vardı. FAI ve kontrol grupları karşılaştırıldığında alfa ve Wiberg açıları anlamlı olarak farklı bulundu (p <0.05). Alt grup analizinde kam tipi ve kontrol grubu, Mix tipi ve kontrol grubu, Pincer tipi ve kam tipi, Pincer tipi ve alfa açıları arasındaki karışım tipi (p <0.05) ile Pincer tipi ve kontrolü arasında istatistiksel olarak anlamlı bir fark vardı. grup ve kam ve karışım türü arasında fark yoktu (p> 0.05).
Wiberg açıları için Pincer tipi ve kontrol grubu, Mix tipi ve kontrol grubu, pincer tipi ve kam tipi, Mixt tipi ve kam tipi arasında anlamlı bir fark bulunmuştur (p <0.05). Kam tipi ve kontrol grubu ile Pincer tipi ve -mixt tipi arasında fark yoktu (p> 0.05). Kesme değerleri alfa açısı için 54,45 (auc = 0,64) ve Wiberg açısı için 37,30 (auc = 0,83) idi.
Sonuç: Alfa açısı ölçümü kam tipi ve Wiberg açısı ölçümü MRG ile kıskaç tipi sıkışma tanısı için yararlı bilgiler sağlar.
Keywords
References
- 1. Keogh MJ, Batt ME. A review of femoroacetabular impingement in athletes. Sports Med 2008; 38: 863-78.
- 2. Matcuk Jr GR, Price SE, Patel DB, White EA, Cen S. Acetabular labral tear description and measures of pincer and cam-type femoroacetabular impingement and interobserver variability on 3 T MR arthrograms. Clinical Imaging 2018; 50: 194-200.
- 3. Griffin DR, Dickenson EJ, O’donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 2016; 50: 1169-76.
- 4. Parvizi J, Leunig M, & Ganz R. Femoroacetabular impingement. JAAOS-J Am Academy Orthopaedic Surg 2007; 15: 561-70.
- 5. Dudda M, Albers C, Mamisch TC, Werlen S, Beck M. Do normal radiographs exclude asphericity of the femoral headneck junction? Clin Orthop Relat Res 2009; 467: 651–9.
- 6. Barton C, Salineros MJ, Rakhra KS, Beaulé PE. Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthopaedics Related Res 2011; 469: 464-9.
- 7. Ersan Ö, Yıldız Y, Ateş Y. Femoroasetabuler sıkışma. Totbid Derg 2010; 9: 107-14.
- 8. Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthopaedics Related Res 2004; 429: 170-7.
- 9. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. Am J Roentgenol 2007; 188: 1540-52.
- 10. Laborie LB, Lehmann TG, Engesæter IØ, Eastwood DM, Engesæter LB, Rosendahl K. Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults. Radiology 2011; 260: 494-502.
- 11. Azboy I, Ceylan HH, Groff H, Vahedi H, Parvizi J. Bilateral femoroacetabular impingement: What is the fate of the asymptomatic hip?. Clin Orthopaedics Related Res 2019; 477: 983-9.
- 12. Allen D, Beaulé PE, Ramadan O, Doucette S. Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement. The Journal of bone and joint surgery. British Vol 2009; 91: 589-94.
- 13 Şahin N, Atıcı T, Öztürk A, Özkaya G, Avcu B, Özkan Y. Kronik kalça ağrısı ile femoroasetabuler sıkışma arasındaki ilişki: Klinik bulgular ve radyografi ile değerlendirme. Eklem Hast Cerr 2011; 22: 129-33.
- 14. Hatakeyama A, Utsunomiya H, Nishikino S, et al. Predictors of poor clinical outcome after arthroscopic labral preservation, capsular plication, and cam osteoplasty in the setting of borderline hip dysplasia. Am J Sports Med 2018; 46: 135-43.
- 15. Chen L, Boonthathip M, Cardoso F, Clopton P, Resnick D. Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria—a correlative study with measurement derived from conventional radiography. Skeletal Radiol 2009; 38: 123-9.
- 16. Monazzam S, Bomar JD, Cidambi K, Kruk P, Hosalkar H. Lateral center-edge angle on conventional radiography and computed tomography. Clin Orthopaedics Related Res 2013; 471: 2233-37.
- 17. Chadayammuri V, Garabekyan T, Jesse MK, at al. Measurement of lateral acetabular coverage: a comparison between CT and plain radiography. J Hip Preservation Surg 2015; 2: 392-400.
- 18. Ji HM, Baek JH, Kim KW, Yoon JW, Ha YC. Herniation pits as a radiographic indicator of pincer-type femoroacetabular impingement in symptomatic patients. Knee Surg Sports Traumatol Arthroscopy 2014; 22: 860-6
Abstract
Introduction: It was aimed to compare the patients having clinical and radiological diagnosis of femoroacetabular impingement syndrome with the control group by magnetic resonance imaging, and alpha angle and the central corner angle described by Wiberg.
Material and Method: Routine hip MRIs were analyzed retrospectively between January 2016 and May 2019. Clinically and radiologically, patients diagnosed with cam, pincer, and mixed FAI were recorded. A control group matching age and sex was created. The alpha angle was determined as the angle between the line drawn from the center of the femoral neck to the center of the femoral head in axial T1A magnetic resonance imaging, and the line drawn from the center of the femoral head to the point where the femoral head begins to turn towards the neck.Central corner angle of Wiberg’s was measured as the angle between the perpendicular line drawn from the center of the femoral head to the acetabulum on the coronal T1A images and the line connecting the outermost point of the acetabulum. Measurements were compared statistically in both groups. p<0.05 was considered statistically significant.
Results: 16 of 28 patients (18 men, 10 women) with FAI had impingement in both hips and a total of 44 hips were examined. There were 9 cam, 23 pincer and 12 mixed impingement cases in the patient group. When FAI and control groups were compared, alpha and Wiberg’s angles were found to be significantly different (p<0.05). In subgroup analysis, there was a significant difference between cam type and control group, mixed type and control group, pincer type and cam type, pincer type and mixed type in terms of alpha angles (p<0.05). For Wiberg’s angles, a significant difference was found between pincer type and control group, mixed type and control group, pincer type and cam type, mixed type and cam type (p<0.05). Cut off values were 54.45 (auc=0.64) for alpha angle and 37.30 (auc=0.83) for Wiberg angle.
Conclusion: Alpha angle measurement cam type and Wiberg angle measurement provide useful information for the diagnosis of pincer type impingement with MRI.
Keywords
References
- 1. Keogh MJ, Batt ME. A review of femoroacetabular impingement in athletes. Sports Med 2008; 38: 863-78.
- 2. Matcuk Jr GR, Price SE, Patel DB, White EA, Cen S. Acetabular labral tear description and measures of pincer and cam-type femoroacetabular impingement and interobserver variability on 3 T MR arthrograms. Clinical Imaging 2018; 50: 194-200.
- 3. Griffin DR, Dickenson EJ, O’donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 2016; 50: 1169-76.
- 4. Parvizi J, Leunig M, & Ganz R. Femoroacetabular impingement. JAAOS-J Am Academy Orthopaedic Surg 2007; 15: 561-70.
- 5. Dudda M, Albers C, Mamisch TC, Werlen S, Beck M. Do normal radiographs exclude asphericity of the femoral headneck junction? Clin Orthop Relat Res 2009; 467: 651–9.
- 6. Barton C, Salineros MJ, Rakhra KS, Beaulé PE. Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthopaedics Related Res 2011; 469: 464-9.
- 7. Ersan Ö, Yıldız Y, Ateş Y. Femoroasetabuler sıkışma. Totbid Derg 2010; 9: 107-14.
- 8. Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthopaedics Related Res 2004; 429: 170-7.
- 9. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. Am J Roentgenol 2007; 188: 1540-52.
- 10. Laborie LB, Lehmann TG, Engesæter IØ, Eastwood DM, Engesæter LB, Rosendahl K. Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults. Radiology 2011; 260: 494-502.
- 11. Azboy I, Ceylan HH, Groff H, Vahedi H, Parvizi J. Bilateral femoroacetabular impingement: What is the fate of the asymptomatic hip?. Clin Orthopaedics Related Res 2019; 477: 983-9.
- 12. Allen D, Beaulé PE, Ramadan O, Doucette S. Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement. The Journal of bone and joint surgery. British Vol 2009; 91: 589-94.
- 13 Şahin N, Atıcı T, Öztürk A, Özkaya G, Avcu B, Özkan Y. Kronik kalça ağrısı ile femoroasetabuler sıkışma arasındaki ilişki: Klinik bulgular ve radyografi ile değerlendirme. Eklem Hast Cerr 2011; 22: 129-33.
- 14. Hatakeyama A, Utsunomiya H, Nishikino S, et al. Predictors of poor clinical outcome after arthroscopic labral preservation, capsular plication, and cam osteoplasty in the setting of borderline hip dysplasia. Am J Sports Med 2018; 46: 135-43.
- 15. Chen L, Boonthathip M, Cardoso F, Clopton P, Resnick D. Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria—a correlative study with measurement derived from conventional radiography. Skeletal Radiol 2009; 38: 123-9.
- 16. Monazzam S, Bomar JD, Cidambi K, Kruk P, Hosalkar H. Lateral center-edge angle on conventional radiography and computed tomography. Clin Orthopaedics Related Res 2013; 471: 2233-37.
- 17. Chadayammuri V, Garabekyan T, Jesse MK, at al. Measurement of lateral acetabular coverage: a comparison between CT and plain radiography. J Hip Preservation Surg 2015; 2: 392-400.
- 18. Ji HM, Baek JH, Kim KW, Yoon JW, Ha YC. Herniation pits as a radiographic indicator of pincer-type femoroacetabular impingement in symptomatic patients. Knee Surg Sports Traumatol Arthroscopy 2014; 22: 860-6
Details
| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
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| Publication Date | June 18, 2020 |
| Published in Issue | Year 2020 Volume: 3 Issue: 3 |
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