Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients

Abstract

Purpose: To retrospectively characterize magnetic resonance (MR) arthrographic findings in patients with cam femoroacetabular impingement (FAI) and in those with pincer FAI.

Materials and methods: Institutional review board approval and informed consent were not required. MR arthrographic studies obtained in 50 consecutive patients (30 men, 20 women; mean age, 28.8 years) with FAI were analyzed for labral abnormalities, cartilage lesions, and osseous abnormalities of the acetabular rim. The nonspherical shape of the femoral head at the head-neck junction was measured in eight positions around the femoral head and neck and used to calculate the alpha angle. Acetabular depth was measured. Surgical diagnosis served as the reference standard. The Wilcoxon rank sum test was used for statistical analysis.

Results: At surgery, hips in 33 patients were classified as having cam FAI and hips in 17 patients were classified as having pincer FAI. In both groups, the mean age of patients was 28.8 years. There were significantly more men (n = 27) with cam FAI and more women (n = 14) with pincer FAI. The alpha angle was significantly larger in patients with cam FAI at the anterior and anterosuperior positions. The acetabulum was significantly deeper in patients with pincer FAI than in patients with cam FAI. Cartilage lesions at the anterosuperior and superior positions were significantly larger in patients with cam FAI than in patients with pincer FAI. Cartilage lesions at the posteroinferior position were significantly larger and labral lesions at the posterior and posteroinferior positions were more pronounced in patients with pincer FAI than in patients with cam FAI. Osseous abnormalities were not significantly different between the groups. Osseous bump formation at the femoral neck was significantly more common in patients with cam FAI than in patients with pincer FAI.

Conclusion: Characteristic MR arthrographic findings of cam FAI include large alpha angles and cartilage lesions at the anterosuperior position and osseous bump formation at the femoral neck; characteristic findings of pincer FAI include a deep acetabulum and posteroinferior cartilage lesions.