Hip Impingement: Identifying and Treating a Common Cause of Hip Pain
Authors: Kuhlman GS, Domb BG
PMID: 20000305
Purpose
To educate primary care and frontline providers on the diagnosis and management of femoroacetabular impingement (FAI), a prevalent yet underrecognized source of hip pain in young active patients.
Methods
Narrative review summarizing FAI pathophysiology, clinical presentation, diagnostic maneuvers, imaging modalities, and treatment options including arthroscopic surgery.
Key Findings
- FAI results from abnormal contact between femoral head and acetabulum, frequently causing labral pathology.
- Clinical presentation includes groin or anterolateral hip pain, exacerbated by flexion and rotation maneuvers.
- Physical exam tests such as FADIR and FABER aid diagnosis.
- Imaging and diagnostic intra-articular injections confirm the diagnosis.
- While physical therapy may help, arthroscopic intervention is often required to prevent progression to osteoarthritis.
Conclusion
Early recognition and appropriate management of FAI are critical to improving patient outcomes and preventing degenerative hip disease.
What Does This Mean for Providers?
Maintain a high index of suspicion for FAI in young, active patients presenting with hip or groin pain. Use targeted physical exam maneuvers and imaging judiciously to diagnose, and refer appropriately for arthroscopic evaluation to optimize patient outcomes.