Prevalence of radiological femoroacetabular impingement in Japanese hip joints: detailed investigation with computed tomography

J Orthop Sci. 2015 Jul;20(4):649-56. doi: 10.1007/s00776-015-0733-5. Epub 2015 May 12.

Abstract

Background: Femoroacetabular impingement (FAI) has been highlighted as a new etiology for osteoarthritis of the hip, and its prevalence has been reported in the past decade. In the present study, we performed a detailed investigation of the anatomical parameters related to FAI and calculated the prevalence of FAI-related findings in asymptomatic Japanese hip joints using computed tomography.

Methods: We evaluated high-resolution reconstructed multislice computed tomography images in patients who had undergone computed tomography imaging in our institution for conditions unrelated to hip disorders. The examined parameters were as follows: center-edge (CE) angle; acetabular index; acetabular anteversion (five slices in the axial plane); and asphericity angle of the femoral head (AAFH) (six slices in multiple radial planes). The AAFH in the oblique axial slice through the center of the femoral neck is the so-called α-angle. We then examined the accurate prevalence of FAI-related findings in Japan.

Results: We investigated a total of 103 hips. The mean age of the subjects was 59.4 years. The mean CE angle was 31.1° and the mean acetabular index was 7.0°. The mean acetabular anteversion was 20.3° at the level of the hip center, and decreased as the slice level neared the superior margin of the femoral head. The mean AAFH ranged from 40.6° to 49.2° in the radial planes. The AAFH was largest at 60° rotated slice from the oblique axial slice through the center of the femoral neck. The prevalence of FAI-related findings in these Japanese hip joints was assessed as follows. An AAFH of >50° in any slice was detected in 51.5 % of the hips, and acetabular anteversion was negative for all images in 16.5 % of the hips, meaning that a total of 56.3 % of the images met the criteria for radiological FAI.

Conclusions: With consideration of our results, we emphasize that "anatomical or radiological FAI" is not uncommon in Japanese hips. Therefore, the diagnosis of FAI should be performed with the clinical findings taken into account.

MeSH terms

  • Female
  • Femoracetabular Impingement / diagnostic imaging
  • Femoracetabular Impingement / epidemiology*
  • Hip Joint / diagnostic imaging*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Prevalence
  • Retrospective Studies