The Painful Hip in Young Adults Between Impingement and Mild Dysplasia: Clinical and Instrumental Diagnostical Criteria

Main Article Content

Paolo Lorenzon
Andrea Scalvi
Enrico Scalco


Impingement, Dysplasia, Hip arthritis.


Femoroacetabular impingement and developmental dysplasia of the hip are among the main causes of hip arthritis. In absence of degenerative alterations of the hip, there is the chance of a surgical conservative treatment. This study aims to show the clinical and imaging criteria to a correct and prompt diagnosis.


Download data is not yet available.


Metrics Loading ...
Abstract 145 | PDF Downloads 66


1. Ganz R, Leunig M, Leunig-Ganz M, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 2008; 466: 264-72.
2. Parvizi J, Campfield A, Clohisy JC, Rothman RH, Mont MA. Management of arthritis of the hip in the young adult. J bone Joint Surg 2006; 88B, n. 10: 1279-85.
3. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003; 417: 112–20.
4. Siebenrock KA, Behning A, Mamisch TC, Schwab JM. Growth plate alteration precedes cam-type deformity in elite basketball players, Clin Orthop Relat Res. 2013; 471(4): 1084-91.
5. Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971; 53: 406–19.
6. Bombelli R, Osteoarthritis of the hip: pathogenesis and consequent therapy, Springer, Berlin 1976.
7. Murphy SB, Ganz R, Muller ME. The prognosis of untreated hip dysplasia: factors predicting outcome. J Bone Joint Surg Am 1995; 77: 985-89.
8. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005; 87: 1012-18.
9. Eijer H, Podeszwa D, Ganz R, Leunig M. Evaluation and treatment of young adults with femoro-acetabular impingement secondary to Perthes' disease. Hip Int. 2006; 16: 273-80.
10. Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986; 213: 20-33.
11. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003; 417: 112-20.
12. Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip: a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001; 83: 1119-24.
13. Hozack WJ, Parviz J, Bender B. Surgical treatment of hip arthritis: recostruction, replacement, revision, Sanders Elsevier, Philadelphia 2010.
14. Tannas M, Mistry S, Steppacher SD, Reichenbach S, Langlotz F, Siebenrock KA, Zheng G. Radiographic analysis of femoroacetabular impingement with Hip Norm-reliable and validated, J Orthop Res 2008; 26: 1199–205.
15. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol.2007; 188: 1540–52.
16. Tannast M, Fritsch S, Zheng G, Siebenrock KA, Steppacher SD. Which radiographic hip parameters do not have to be corrected for pelvic rotation and tilt? Clin Orthop Relat Res 2015; 473(4) 1255-66.
17. Tannast M, Hanke MS, Zheng G, Steppacher SD, Siebenrock KA. What Are the Radiographic Reference Values for Acetabular Under- and Overcoverage? Clin Orthop Relat Res 2015; 473(4): 1234-46.
18. Kalberer F, Sierra RJ, Madan SS, Ganz R, Leunig M. Ischial spine projection into the pelvis: a new sign for acetabular retroversion. Clin Orthop Relat Res. 2008; 466: 677–83.
19. Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999; 81: 1747–70.
20. Corten K, Ganz R, Chosa E, Leunig M. Bone apposition of the acetabular rim in deep hips: a distinct finding of global pincer impingement. J Bone Joint Surg Am 2011; 93(Suppl 2): 10–6.
21. Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R. Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 2005; 236: 237-46.
22. Gao Z, Yin J, Ma L, Wang J, Meng Q. Clinical imaging characteristics of herniation pits of the femoral neck. Orthop Surg. 2009; 1: 189–95.
23. Hanke MS, Steppacher S, Anwander H, Werlen S, Siebenrock KA, Tannast M. What MRI Findings Predict Failure 10 Years After Surgery for Femoroacetabular Impingement? Clin Orthop Relat Res. 2017; 475(4): 1192–207.
24. Czerny C, Hofmann S, Neuhold A, Tschauner C, Engel A, Recht MP, Kramer J. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology. 1996; 200: 225–30.
25. Steppacher SD, Anwander H, Zurmühle CA, Tannast M, Siebenrock KA. Eighty percent of patients with surgical hip dislocation for femoroacetabular impingement have a good clinical result without osteoarthritis progression at 10 years. Clin Orthop Relat Res. 2015; 473: 1333–341.
26. Steppacher SD, Huemmer C, Schwab JM, Tannast M, Siebenrock KA. Surgical hip dislocation for treatment of femoroacetabular impingement: factors predicting 5-year survivorship. Clin Orthop Relat Res. 2014; 472: 337–48.
27. Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-Year Follow-up of Bernese Periacetabular Osteotomy. Clin Orthop Relat Res 2008; 466(7): 1633-44.
28. Lerch T, Tannast M, Steppacher S, Siebenrock KA, Thirty years follow up after bernese periacetabular osteotomy, Orthopaedic Proceedings 2018; 9-B supp 4: 122.