Is a Positive Femoroacetabular Impingement Test a Common Finding in Healthy Young Adults?

Abstract

Background Femoroacetabular impingement (FAI) is an incompletely understood clinical concept that implies pathomechanical changes in the hip as a cause for hiprelated pain in young adults. While a positive anterior impingement test is suggestive of FAI, its association with clinical and radiographic findings remain unconfirmed in healthy young adults. Questions/purposes We determined the prevalence of a positive test in 1170 young adults and examined its possible associations with (1) self-reported hip discomfort for the past 3 months; (2) weekly physical exercise; (3) hip ROM; and (4) radiographic findings associated with femoroacetabular impingement.Methods We invited 2344 healthy 19-year-olds to a population-based hip study between 2008 and 2009; 1170 patients (50%) consented. The study included questionnaires on medical and functional status, a clinical hip examination including the impingement test and hip ROM, and two pelvic radiographs (AP and frog-leg views).Results Based on at least one affected hip, 35 of 480 (7.3%) men and 32 of 672 (4.8%) women had positive impingement tests. Eighteen of the 1170 patients were excluded owing to suboptimal or missing radiographs. Self-reported hip discomfort in the women and increased physical exercise in the men were strongly associated with the positive impingement tests. Decreased abduction and internal rotation in the men, decreased flexion in both genders, and radiographic cam type findings in the men also were associated with positive tests.

Revision Hip Arthroscopy Indications and Outcomes: A Systematic Review

“…Laborie et al 31 and Hetsroni et al 32 have previously reported cam radiographic findings of FAI to 25 The authors reported improved outcomes after arthroscopic hip revision surgery for residual FAI. These were found to be inferior to the index surgery.…”

Does bony hip morphology affect the outcome of treatment for patients with adductor-related groin pain? Outcome 10 years after baseline assessment

“…Another possibility is that the range of motion restrictions due to FAI creates compensatory patterns that affect extra-articular pelvic structures and could lead to the development of muscle and tendon overload, such as long-standing adductor-related groin pain. 1 28 The decrease in range of motion (ROM) that is commonly seen with FAI29 could during sports, especially those with cutting activities, lead to altered recruitment of the muscles and in turn to overuse and an increased risk of injury. A similar analysis was not meaningful in the PT group because of the poor clinical outcome resulting in a floor effect.…”

Hip Imaging in Athletes: Sports Imaging Series

“…Impingement tests, such as the hip flexion-adductioninternal rotation test, show overall good sensitivity but lack sufficient specificity (69). The impingement test may even be positive in about 5%-7% of asymptomatic young adults (70).…”