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What You Might Not Know About Hip Pain: What Are the Mysterious Symptoms of Hip Impingement?
Femoroacetabular Impingement (FAI) is a health condition associated with an abnormal anatomical structure of the hip joint, a ball-and-socket joint, that commonly occurs in young and middle-aged adults and causes hip pain and Discomfort. This condition occurs when the femoral head of the hip does not make proper contact with the acetabulum or does not have a normal range of motion. The pain of FAI often presents inconsistently throughout the hip joint and surrounding area and can lead to damage to the articular cartilage or annular soft tissue, and even in some cases osteoarthritis of the hip.
Hip impingement may be asymptomatic or symptomatic, and the presence of symptoms may interfere with daily activities.
FAI symptoms and diagnosis
The most common complaint among patients with FAI is pain, usually in the groin, upper buttocks, lower back, side of the affected hip, and posterior upper leg. The onset of pain can be sudden or gradual and often results in decreased mobility. Patients are often unable to complete activities involving high hip flexion or prolonged sitting. It is important to note that some patients may experience groin pain during certain activities without a history of prior trauma.
The pain is often intense enough to cause reduced activity and limited movement.
Causes of FAI
FAI is characterized by abnormal contact between the proximal femur and the acetabular rim. Patients usually show deformities of the femoral head or acetabulum, dislocation of the junction of the femur and acetabulum, etc. The specific cause of FAI is still unclear, and it may be caused by congenital or acquired factors. There are studies on the market that indicate an increasing trend of cases occurring between siblings, suggesting there may be a genetic component.
Hip Anatomy
The hip joint is classified as a ball-and-socket joint, a synovial joint that allows for multi-directional movement and rotation. The hip joint consists of two bones between the femur and pelvis, a connection that connects the central skeleton to the lower extremity. Its major nerve supplies are the femoral and sciatic nerves.
Diagnostic Process
Clinical assessment is the first step in diagnosis, but due to the inconsistent and ambiguous nature of pain, it is difficult to reach a definitive diagnosis by this step alone. A detailed medical history and current activities should be obtained. Additionally, the physical examination should assess passive internal rotation of the hip to check for decreased range of motion; the FADDIR and FABER tests should also be performed and are particularly important in diagnosing cricoid lesions.
X-rays and other imaging tests
Currently, X-ray standing fluoroscopy technology is widely used in the preliminary diagnosis of FAI. In addition to X-rays, MRI imaging may also be performed later, especially when clear signs cannot be seen on X-rays. MRI produces a three-dimensional reconstruction of the joint, allowing for a clearer assessment of the cartilage structure of the hip.
Treatment options
The treatment of FAI can be divided into non-surgical (conservative) and surgical. Conservative treatment is usually offered to people who have not started other treatments and mainly consists of physical therapy and avoiding activities that cause pain. Depending on the patient's needs, joint injections of steroids or hyaluronic acid may also be an option. If conservative treatment fails to relieve symptoms, surgical treatment is recommended to correct the bony abnormalities and soft tissue damage that caused the impingement and thereby improve the fit of the femoral head and acetabulum.
EpidemiologyThe success rate of surgical treatment is generally high, and most athletes can successfully return to the competitive field.
There is limited research on the prevalence of FAI in the general population, but multiple studies on young athletes have shown an increased incidence in white people and in some sports (e.g., ice hockey, Tennis and football) have a higher incidence of hip abnormalities.
The study of hip impingement not only provides us with an understanding of the relevant bone structure and symptoms, but also reminds us of the potential risks and importance of maintenance in our daily lives. So, after understanding the various symptoms and treatments of FAI, will you pay more attention to your hip health?
