Association Between Cam-type Femoroacetabular Impingement and Osteitis Pubis in Non-athletic Population on Magnetic Resonance Imaging

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2019 Oct 24

PMID 31640735

Citations 4

Authors

Ayse Serap Akgun

Mehmet Agirman

Affiliations

Soon will be listed here.

Abstract

Background: Osteitis pubis (OP) is a common source of groin and extra-articular hip pain and is associated with intra-articular hip pathology. In this study, we aimed to determine the prevalence of osteitis pubis on magnetic resonance imaging (MRI) in non-athletic patients with cam-type femoroacetabular impingement (FAI).

Methods: This retrospective cross-sectional study included 178 subjects: 90 patients with cam-type FAI diagnosed by MRI and 88 subjects used as a control group. Additionally, their MRI data were analyzed for the characteristics of osteitis pubis, with severity graded from minimal to severe on a four-point scale.

Results: A total of 98 patients and 88 controls were studied. Seventy-two males (80%) and 18 females (20%) were the patient group, whereas 71 males (80.68%) and 17 females (19.32%) were the control group. The mean alpha angle of the patients with FAI was 65.8 ± 3.3° in the right side and 66.2 ± 3.2° in the left side, whereas in the control group, it was 47 ± 5.6° in the right side and 47.8 ± 5.2° in the left side. Alpha angle measurements were significantly higher in the patient group than the control group (p < 0.001). A statistically significant increase in the prevalence of osteitis pubis was found in patients with cam-type FAI (45.56%) compared to control subjects (5.68%) (p < 0.001).

Conclusions: This study demonstrated that the frequency of osteitis pubis was increased in non-athletic patients with FAI syndrome. Further studies are required to determine whether these findings reflect the clinical symptoms in patients with hip pain.

Citing Articles

Primary care level prevalence of osteitis pubis in non-athlete patients in hill region: A short communication and a proposal for simple radiological grading.

Dharmshaktu G J Family Med Prim Care. 2023; 12(4):783-787.

PMID: 37312763 PMC: 10259561. DOI: 10.4103/jfmpc.jfmpc_105_21.

Hip Range of Motion and Strength in Male Athletes with Stage 1 Osteitis Pubis: A Cross-Sectional and Correlational Study.

Ceballos-Laita L, Hernando-Garijo I, Medrano-de-la-Fuente R, Mingo-Gomez M, Carrasco-Uribarren A, Jimenez-Del-Barrio S Int J Environ Res Public Health. 2022; 19(19).

PMID: 36232123 PMC: 9564700. DOI: 10.3390/ijerph191912824.

Editorial.

Field R J Hip Preserv Surg. 2022; 8(4):309-310.

PMID: 35505806 PMC: 9052428. DOI: 10.1093/jhps/hnac014.

The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia.

Shimodaira H, Hatakeyama A, Suzuki H, Takada S, Murata Y, Sakai A J Hip Preserv Surg. 2022; 8(4):318-324.

PMID: 35505801 PMC: 9052425. DOI: 10.1093/jhps/hnab081.

References

Notzli H, Wyss T, Stoecklin C, Schmid M, Treiber K, Hodler J . The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002; 84(4):556-60. DOI: 10.1302/0301-620x.84b4.12014. View

Ganz R, Leunig M, Leunig-Ganz K, Harris W . The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008; 466(2):264-72. PMC: 2505145. DOI: 10.1007/s11999-007-0060-z. View

Ratzlaff C, Zhang C, Korzan J, Josey L, Wong H, Cibere J . The validity of a non-radiologist reader in identifying cam and pincer femoroacetabular impingement (FAI) using plain radiography. Rheumatol Int. 2015; 36(3):371-6. PMC: 5762185. DOI: 10.1007/s00296-015-3361-7. View

Paajanen H, Heikkinen J, Hermunen H, Airo I . Successful treatment of osteitis pubis by using totally extraperitoneal endoscopic technique. Int J Sports Med. 2005; 26(4):303-6. DOI: 10.1055/s-2004-820975. View

Larson C, Pierce B, Giveans M . Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series. Arthroscopy. 2011; 27(6):768-75. DOI: 10.1016/j.arthro.2011.01.018. View

Parvizi J, Campfield A, Clohisy J, Rothman R, Mont M . Management of arthritis of the hip in the young adult. J Bone Joint Surg Br. 2006; 88(10):1279-85. DOI: 10.1302/0301-620X.88B10.17859. View

Larson C, Sikka R, Sardelli M, Byrd J, Kelly B, Jain R . Increasing alpha angle is predictive of athletic-related "hip" and "groin" pain in collegiate National Football League prospects. Arthroscopy. 2013; 29(3):405-10. DOI: 10.1016/j.arthro.2012.10.024. View

Birmingham P, Kelly B, Jacobs R, McGrady L, Wang M . The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study. Am J Sports Med. 2012; 40(5):1113-8. DOI: 10.1177/0363546512437723. View

Fricker P . Management of groin pain in athletes. Br J Sports Med. 1997; 31(2):97-101. PMC: 1332605. DOI: 10.1136/bjsm.31.2.97. View

10.

Clohisy J, Nunley R, Otto R, Schoenecker P . The frog-leg lateral radiograph accurately visualized hip cam impingement abnormalities. Clin Orthop Relat Res. 2007; 462:115-21. DOI: 10.1097/BLO.0b013e3180f60b53. View

11.

Lohan D, Seeger L, Motamedi K, Hame S, Sayre J . Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer?. Skeletal Radiol. 2009; 38(9):855-62. DOI: 10.1007/s00256-009-0745-3. View

12.

Verrall G, Hamilton I, Slavotinek J, Oakeshott R, Spriggins A, Barnes P . Hip joint range of motion reduction in sports-related chronic groin injury diagnosed as pubic bone stress injury. J Sci Med Sport. 2005; 8(1):77-84. DOI: 10.1016/s1440-2440(05)80027-1. View

13.

SWEETNAM D . OSTEITIS PUBIS IN AN OLYMPIC ROAD-WALKER. Proc R Soc Med. 1964; 57:88-90. PMC: 1897807. View

14.

Rodriguez C, Miguel A, Lima H, Heinrichs K . Osteitis Pubis Syndrome in the Professional Soccer Athlete: A Case Report. J Athl Train. 2003; 36(4):437-440. PMC: 155442. View

15.

Pfirrmann C, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J . Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology. 2006; 240(3):778-85. DOI: 10.1148/radiol.2403050767. View

16.

Ganz R, Gill T, 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. 2002; 83(8):1119-24. DOI: 10.1302/0301-620x.83b8.11964. View

17.

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock K . Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003; (417):112-20. DOI: 10.1097/01.blo.0000096804.78689.c2. View

18.

Leunig M, Fraitzl C, Ganz R . [Early damage to the acetabular cartilage in slipped capital femoral epiphysis. Therapeutic consequences]. Orthopade. 2002; 31(9):894-9. DOI: 10.1007/s00132-002-0378-x. View

19.

Khan W, Zoga A, Meyers W . Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice. Magn Reson Imaging Clin N Am. 2012; 21(1):97-110. DOI: 10.1016/j.mric.2012.09.008. View

20.

Matsuda D . Endoscopic pubic symphysectomy for reclacitrant osteitis pubis associated with bilateral femoroacetabular impingement. Orthopedics. 2010; 33(3). DOI: 10.3928/01477447-20100129-31. View