Background Age of onset in symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement syndrome (FAIS) varies. The purpose of this study was to investigate whether psychological factors, radiographic, and clinical variables were related to age of onset of hip pain in DDH and FAIS. Methods We collected demographic, clinical, and radiographic data on 56 DDH and 84 FAIS patients. Each was diagnosed based on radiographic findings and clinical history. Age of onset was operationalized by subtracting patient reported duration of symptoms from patient age at presentation. Pain catastrophizing (PCS) and depression were assessed with the pain catastrophizing scale and hospital anxiety and depression scale (HADS), respectively. Multiple linear regression modeling, with Lasso variable selection, was implemented. Results Pain catastrophizing, anxiety, and depression were not significantly related to age of DDH onset ( p -values > 0.27) or age of FAIS onset ( p -values > 0.29). LASSO-penalized linear regression revealed alpha Dunn angle, Tonnis grade, prior hip surgery, WOMAC pain score, and iHOT total score were associated with age of onset in FAIS (Adjusted R 2 = 0.3099). Lateral center edge angle (LCEA), alpha frog angle, Tonnis grade, SF12 physical functioning, and body mass index (BMI) were associated with age of DDH onset (Adjusted R 2 = 0.3578). Conclusions Psychological factors, as measured by PCS and HADS, were not associated with age of onset in DDH or FAIS. Functional impairment as measured by WOMAC pain and impaired active lifestyle as measured by iHOT were found to affect age of FAIS onset. For DDH, impaired physical functioning and increasing BMI were found to be associated with age of onset. Severity of the disease, as measured radiographically by LCEA and alpha Dunn angle, was also found to be associated with earlier age of onset in DDH and FAIS, respectively. A patient’s radiographic severity may have more of a relationship to the onset of pain than physiologic factors.

The relationship among the severity of the imaging features of femoroacetabular impingement syndrome (FAIS), patient symptoms, and function has not been elucidated. Understanding this relationship helps to improve the prognostic value of imaging. The goal of this study was to examine the correlation of clinical findings, patient pain, and function with severity, as measured with radiographic and 3-dimensional magnetic resonance imaging (3D-MRI). Data collected prospectively through a longitudinally maintained hip database were reviewed, and 37 hips from 31 patients were included. All patients were examined by an experienced orthopedic surgeon, and preoperative radiographs and 3D-MRI were obtained. Preoperatively, the patients completed validated patient-reported outcome measures (PROMs). Mean±SD alpha angles were 69.4°±10.3°, 70.0°±10.3°, 70.6°±8.4°, and 74.8°±9.2° at 12 o'clock, 1 o'clock, 2 o'clock, and 3 o'clock, respectively. Mean lateral center edge angle was 30.1°±5.3°. The authors did not observe a statistically significant correlation between PROMs and the features measured by radiographs and 3D-MRI ( P >.05). In this subset of prospectively imaged patients with FAIS, the authors did not find a correlation between the severity of symptoms measured by PROMs and features on radiographs and 3D-MRI. The severity of dysfunction is multifactorial, and anatomic severity, as measured radiographically and with 3D-MRI, may not correlate with symptoms. Further investigation is necessary to address the sources of patient pain. [ Orthopedics . 2021;44(4):e577–e582.]

treatment at 1 and 3 months respectively. Graph I (A,B) showed the discontinuation reasons. 36 out of 92 women were evaluated at 6 months with a high drug adherence (median MMAS-4 score of 0 (range 0-2) ). At 6 months follow-up patient's satisfaction was high, infact median PGI-I and S-VAS were 2 (range 1-4) and 8 (2-10) respectively. At 1,3,6 months OABq-sf score showed a statistically significant improvement with a baseline median score of 36 (range 19-99), of 9 (range 7-24) at 6 months (p¼0.001). Graph 1C showed an improvement of all the OAB symptoms at 1 and 3 months, but they were stable at 6 months. Furthermore a statistically significant decrement of the mean number of pads/die was evident at 6 month (1.45AE1.58 vs 0.57 AE 0.98 p<0.0001).UF results showed no statistical changes at 1 month and at 6 months.The results are not different in women with OAB naïve and women with OAB refractory to antimuscarinic drugs CONCLUSIONS: Mirabegron 50mg showed significant subjective and objective efficacy with a high in women with OAB at 1 and 3 months of treatment. For the low side-effects and its impact on QoL, it can be considered the first line therapy in these patients. Long term results are mandatory for patients perspective and counselling for tailored therapy.