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SOFT TISSUE CAM IMPINGEMENT IN ADOLESCENTS: MRI REVEALS IMPINGEMENT LESIONS UNDERAPPRECIATED ON X-RAY

Orthopaedic journal of sports medicine, 2021-07, Vol.9 (7_suppl3), p.2325967121 [Peer Reviewed Journal]

The Author(s) 2021 ;The Author(s) 2021. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2021 2021 SAGE Publications ;ISSN: 2325-9671 ;EISSN: 2325-9671 ;DOI: 10.1177/2325967121S00063

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  • Title:
    SOFT TISSUE CAM IMPINGEMENT IN ADOLESCENTS: MRI REVEALS IMPINGEMENT LESIONS UNDERAPPRECIATED ON X-RAY
  • Author: Johnson, Benjamin L. ; Alizai, Hamza ; Ben, Montanez ; Wagner, K. John ; Youngman, Tyler ; Ellis, Henry B.
  • Subjects: Teenagers
  • Is Part Of: Orthopaedic journal of sports medicine, 2021-07, Vol.9 (7_suppl3), p.2325967121
  • Description: Background: The presence of femoroacetabular impingement (FAI) in adolescents has been established. However, the existence of a non-ossified CAM lesion in adolescent femoracetabular impingement (FAI) is not well described. Hypthesis/Purpose: The purpose of this study is to evaluate the presence of a non-ossified or soft CAM lesion in adolescent patients with FAI. Methods: A review of a prospective cohort of patients with symptomatic FAI in an institutional registry was performed. Subjects were included if they had an MRI and lateral x-ray of the hip (45o Dunn, Cross Table, or frog) at a baseline visit. On MRI, evaluation of the anterolateral femoral head was evaluated using radial, coronal, sagittal, or axial oblique sequences. When a soft CAM lesion was identified (all found between 2-5 o’clock), an alpha angle was performed on MRI and plain radiograph. The cohort of soft CAM lesions was reviewed and differences between radiographic and MRI alpha angles were assessed using a paired T-Test. Results: Thirty-one (9.3%) of 332 hips (mean age 16.4 yrs, range 13.66-19.59 yrs; 83.9% F) were identified with a soft impinging lesion at the femoral head-neck junction on MRI. The most common primary sport was track & field (4), the average duration of symptoms was 92.4 weeks and a majority with insidious onset (77.4%). The average alpha angle on MRI was greater than on x-ray [63.53 ± 7.94o vs 51.25 ± 7.92o; p<0.05]. All subjects with soft CAM lesions demonstrated soft tissue consistent with extension of the physis (n=1),thickening of the peri-chondral ring (n=22), or thickening of the periosteum (n=8). Twenty-two of these patients (71%) with soft impingement underwent hip preservation surgery (n=13 labral repairs) with improvements in clinical outcome. Conclusion: In adolescent patients with symptomatic hip impingement, MRI may be useful to identify soft CAM lesions (non-ossified) that are under-represented on x-ray.
  • Publisher: Los Angeles, CA: SAGE Publications
  • Language: English
  • Identifier: ISSN: 2325-9671
    EISSN: 2325-9671
    DOI: 10.1177/2325967121S00063
  • Source: Sage Journals Open Access Journals
    Open Access: DOAJ Directory of Open Access Journals
    AUTh Library subscriptions: ProQuest Central
    PubMed Central
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