Skip to main content
SpringerLink
Log in

Validity of US measurements of cam-type femoroacetabular impingement parameters: a preliminary study in an asymptomatic adult population

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the accuracy of US for the quantitative parameters of cam-type femoroacetabular impingement (FAI) in an asymptomatic adult population, using MRI as the reference standard.

Materials and methods

We prospectively evaluated 158 hips of 79 adult subjects (44 males, 35 females; age range 18–49 years) with a negative anterior impingement test. Two observers independently measured anterosuperior quadrant alpha angles and anterior femoral distances (AFDs) on both US and MRI.

Results

US measurements of alpha angle and AFD had a moderate-to-high positive correlation with MRI measurements and there was substantial and/or almost perfect agreement between observers on both imaging modalities. Anterior femoral distance measurements for both observers and alpha angles at MRI for Observer 1 showed no statistically significant difference between genders.

Conclusion

Ultrasonography can be used for anterosuperior alpha angle and AFD measurements in asymptomatic adults. However, when used as the sole imaging method, its inherent limitations and possible discrepancies with MRI should be kept in mind.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. 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.

    Google Scholar 

  2. 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 Jt Surg Br. 2005;87(7):1012–8.

    Article  CAS  Google Scholar 

  3. Tannast M, Goricki D, Beck M, Murphy SB, Siebenrock KA. Hip damage occurs at the zone of femoroacetabular impingement. Clin Orthop Relat Res. 2008;466(2):273–80.

    Article  CAS  PubMed Central  Google Scholar 

  4. Philippon MJ, Maxwell RB, Johnston TL, Schenker M, Briggs KK. Clinical presentation of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2007;15(8):1041–7.

    Article  Google Scholar 

  5. Barton C, Salineros MJ, Rakhra KS, Beaule PE. Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res. 2011;469(2):464–9.

    Article  Google Scholar 

  6. Ergen FB, Vudali S, Sanverdi E, Dolgun A, Aydingoz U. CT assessment of asymptomatic hip joints for the background of femoroacetabular impingement morphology. Diagn Interv Radiol. 2014;20(3):271–6.

    Article  Google Scholar 

  7. Robinson DJ, Lee S, Marks P, Schneider ME. Ultrasound determination of the femoral head-neck alpha angle. Ultrasound Med Biol. 2018;44(2):495–501.

    Article  CAS  Google Scholar 

  8. Samim M, Eftekhary N, Vigdorchik JM, Elbuluk A, Davidovitch R, Youm T, et al. 3D-MRI versus 3D-CT in the evaluation of osseous anatomy in femoroacetabular impingement using Dixon 3D FLASH sequence. Skelet Radiol. 2019;48(3):429–36.

    Article  Google Scholar 

  9. Lohan DG, Seeger LL, Motamedi K, Hame S, Sayre J. Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer? Skelet Radiol. 2009;38(9):855–62.

    Article  Google Scholar 

  10. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Jt Surg Br. 2002;84(4):556–60.

    Article  CAS  Google Scholar 

  11. Buck FM, Hodler J, Zanetti M, Dora C, Pfirrmann CW. Ultrasound for the evaluation of femoroacetabular impingement of the cam type. Diagnostic performance of qualitative criteria and alpha angle measurements. Eur Radiol. 2011;21(1):167–75.

    Article  Google Scholar 

  12. Hsu YC, Wu YC, Wang HH, Lee MS, Huang GS. Assessment of cam-type femoroacetabular impingement by ultrasonography: value of anterior femoral distance measurements. Ultraschall Med. 2012;33(7):E158–E165165.

    Article  Google Scholar 

  13. Lerch S, Kasperczyk A, Warnecke J, Berndt T, Ruhmann O. Evaluation of cam-type femoroacetabular impingement by ultrasound. Int Orthop. 2013;37(5):783–8.

    Article  PubMed Central  Google Scholar 

  14. Mandema L, Tak I, Mooij B, Groeneweg R, Bakker E, van Veldhoven P. Assessment of cam morphology of the hip with ultra sound imaging by physical therapists is reliable and valid. Phys Ther Sport. 2018;32:167–72.

    Article  Google Scholar 

  15. Lerch S, Kasperczyk A, Berndt T, Ruhmann O. Ultrasound is as reliable as plain radiographs in the diagnosis of cam-type femoroacetabular impingement. Arch Orthop Trauma Surg. 2016;136(10):1437–43.

    Article  PubMed Central  Google Scholar 

  16. Orellana C, Moreno M, Calvet J, Navarro N, Garcia-Manrique M, Gratacos J. Ultrasound findings in patients with femoracetabular impingement without radiographic osteoarthritis: a pilot study. J Ultrasound Med. 2019;38(4):895–901.

    Article  PubMed Central  Google Scholar 

  17. Lepage-Saucier M, Thiery C, Larbi A, Lecouvet FE, Vande Berg BC, Omoumi P. Femoroacetabular impingement: normal values of the quantitative morphometric parameters in asymptomatic hips. Eur Radiol. 2014;24(7):1707–14.

    Article  PubMed Central  Google Scholar 

  18. Clohisy JC, Baca G, Beaule PE, Kim YJ, Larson CM, Millis MB, et al. Descriptive epidemiology of femoroacetabular impingement: a North American cohort of patients undergoing surgery. Am J Sports Med. 2013;41(6):1348–56.

    Article  PubMed Central  Google Scholar 

  19. Golfam M, Di Primio LA, Beaule PE, Hack K, Schweitzer ME. Alpha angle measurements in healthy adult volunteers vary depending on the MRI plane acquisition used. Am J Sports Med. 2017;45(3):620–6.

    Article  PubMed Central  Google Scholar 

  20. Aprato A, Masse A, Faletti C, Valente A, Atzori F, Stratta M, et al. Magnetic resonance arthrography for femoroacetabular impingement surgery: is it reliable? J Orthop Traumatol. 2013;14(3):201–6.

    Article  PubMed Central  Google Scholar 

  21. Lerch S, Kasperczyk A, Berndt T, Ruhmann O. Ultrasonography can quantify the extent of osteochondroplasty after treatment of Cam-type femoroacetabular impingement. Int Orthop. 2015;39(5):853–8.

    Article  Google Scholar 

  22. 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.

    Article  Google Scholar 

  23. Sutter R, Dietrich TJ, Zingg PO, Pfirrmann CW. How useful is the alpha angle for discriminating between symptomatic patients with cam-type femoroacetabular impingement and asymptomatic volunteers? Radiology. 2012;264(2):514–21.

    Article  Google Scholar 

  24. Dudda M, Albers C, Mamisch TC, Werlen S, Beck M. Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res. 2009;467(3):651–9.

    Article  Google Scholar 

  25. Domayer SE, Ziebarth K, Chan J, Bixby S, Mamisch TC, Kim YJ. Femoroacetabular cam-type impingement: diagnostic sensitivity and specificity of radiographic views compared to radial MRI. Eur J Radiol. 2011;80(3):805–10.

    Article  CAS  Google Scholar 

  26. Gollwitzer H, Suren C, Struwind C, Gottschling H, Schroder M, Gerdesmeyer L, et al. The natural alpha angle of the femoral head-neck junction. Bone Jt J. 2018;100-B(5):570–8.

    Article  CAS  Google Scholar 

  27. Rakhra KS, Sheikh AM, Allen D, Beaule PE. Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res. 2009;467(3):660–5.

    Article  Google Scholar 

  28. Siebenrock KA, Ferner F, Noble PC, Santore RF, Werlen S, Mamisch TC. The cam-type deformity of the proximal femur arises in childhood in response to vigorous sporting activity. Clin Orthop Relat Res. 2011;469(11):3229–400.

    Article  CAS  PubMed Central  Google Scholar 

  29. Allen D, Beaule PE, Ramadan O, Doucette S. Prevalence of associated deformities and hip pain in patients with cam-type femoroacetabular impingement. J Bone Jt Surg Br. 2009;91(5):589–94.

    Article  CAS  Google Scholar 

  30. Kim J, Choi JA, Lee E, Lee KR. Prevalence of imaging features on CT thought to be associated with femoroacetabular impingement: a retrospective analysis of 473 asymptomatic adult hip joints. AJR Am J Roentgenol. 2015;205(1):W100–W105105.

    Article  Google Scholar 

  31. Ehrmann C, Rosskopf AB, Pfirrmann CW, Sutter R. Beyond the alpha angle: alternative measurements for quantifying cam-type deformities in femoroacetabular impingement. J Magn Reson Imaging JMRI. 2015;42(4):1024–31.

    Article  Google Scholar 

  32. Gosvig KK, Jacobsen S, Palm H, Sonne-Holm S, Magnusson E. A new radiological index for assessing asphericity of the femoral head in cam impingement. J Bone Jt Surg Br. 2007;89(10):1309–16.

    Article  CAS  Google Scholar 

  33. Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Jt Surg Br. 2001;83(2):171–6.

    Article  CAS  Google Scholar 

  34. Jung KA, Restrepo C, Hellman M, AbdelSalam H, Morrison W, Parvizi J. The prevalence of cam-type femoroacetabular deformity in asymptomatic adults. J Bone Jt Surg Br. 2011;93(10):1303–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey

    Sinan Balci, Berna Oguz & Ustun Aydingoz

  2. Department of Sports Medicine, Faculty of Medicine, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey

    Yigitcan Karanfil

Authors
  1. Sinan Balci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yigitcan Karanfil
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Berna Oguz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ustun Aydingoz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sinan Balci.

Ethics declarations

Conflict of interest

Authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balci, S., Karanfil, Y., Oguz, B. et al. Validity of US measurements of cam-type femoroacetabular impingement parameters: a preliminary study in an asymptomatic adult population. Jpn J Radiol 38, 1082–1089 (2020). https://doi.org/10.1007/s11604-020-01005-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-020-01005-4

Keywords

Search

Navigation