Skip to main content
Erschienen in: Skeletal Radiology 8/2020

06.03.2020 | Scientific Article

The prevalence of athletic pubalgia imaging findings on MRI in patients with femoroacetabular impingement

verfasst von: Sowmya Varada, Matthew P. Moy, Fangbai Wu, Michael J. Rasiej, Diego Jaramillo, Tony T. Wong

Erschienen in: Skeletal Radiology | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

To determine the prevalence of athletic pubalgia imaging findings on MRI in patients with femoroacetabular impingement and assess for correlative risk factors.

Materials and methods

A retrospective search identified 156 hips with femoroacetabular impingement and a control group of 113 without femoroacetabular impingement that had an MRI performed between January 1, 2015, and January 1, 2018. Two fellowship-trained musculoskeletal radiologists reviewed studies for the presence of acute osteitis pubis, chronic osteitis pubis, adductor tendinosis, and tendon tear; rectus abdominis tendinosis and tendon tear; and aponeurotic plate tear. Findings were correlated with various clinical and imaging risk factors. Univariate and multivariate statistical analyses were performed.

Results

Imaging findings of adductor tendinosis (p = 0.02) and chronic osteitis pubis (p = 0.01) were more prevalent in FAI patients than controls. Univariate analyses in FAI patients showed that an alpha angle ≥ 60° had a higher prevalence of aponeurotic plate tears (p = 0.02) and adductor tendinosis (p = 0.049). Multivariate analyses showed that an alpha angle ≥ 60° had a higher prevalence of chronic osteitis pubis (OR = 2.27, p = 0.031), sports participation had a higher prevalence of adductor tendon tears (OR = 4.69, p = 0.013) and chronic osteitis pubis (OR = 2.61, p = 0.0058), and males had a higher prevalence of acute osteitis pubis (OR = 5.17, p = 0.032).

Conclusion

Sports participation, alpha angle ≥ 60°, and male sex predict a higher prevalence of athletic pubalgia imaging findings in patients with femoroacetabular impingement.
Literatur
1.
Zurück zum Zitat Byrd JWT. Femoroacetabular impingement in athletes: current concepts. Am J Sports Med. 2014;42(3):737–51.CrossRef Byrd JWT. Femoroacetabular impingement in athletes: current concepts. Am J Sports Med. 2014;42(3):737–51.CrossRef
2.
Zurück zum Zitat Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20.
3.
Zurück zum Zitat Wyles CC, Norambuena GA, Howe BM, Larson DR, Levy BA, Yuan BJ, et al. Cam deformities and limited hip range of motion are associated with early osteoarthritic changes in adolescent athletes: a prospective matched cohort study. Am J Sports Med. 2017;45(13):3036–43.CrossRef Wyles CC, Norambuena GA, Howe BM, Larson DR, Levy BA, Yuan BJ, et al. Cam deformities and limited hip range of motion are associated with early osteoarthritic changes in adolescent athletes: a prospective matched cohort study. Am J Sports Med. 2017;45(13):3036–43.CrossRef
4.
Zurück zum Zitat Cohen B, Kleinhenz D, Schiller J, Tabaddor R. Understanding athletic pubalgia: a review. R I Med J. 2016;99(10):31–5. Cohen B, Kleinhenz D, Schiller J, Tabaddor R. Understanding athletic pubalgia: a review. R I Med J. 2016;99(10):31–5.
5.
Zurück zum Zitat Strosberg DS, Ellis TJ, Renton DB. The role of femoroacetabular impingement in core muscle injury/athletic pubalgia: diagnosis and management. Front Surg. 2016;3:6.CrossRef Strosberg DS, Ellis TJ, Renton DB. The role of femoroacetabular impingement in core muscle injury/athletic pubalgia: diagnosis and management. Front Surg. 2016;3:6.CrossRef
6.
Zurück zum Zitat Poor AE, Roedl JB, Zoga AC, Meyers WC. Core muscle injuries in athletes. Curr Sports Med Rep. 2018;17(2):54–8.CrossRef Poor AE, Roedl JB, Zoga AC, Meyers WC. Core muscle injuries in athletes. Curr Sports Med Rep. 2018;17(2):54–8.CrossRef
7.
Zurück zum Zitat McSweeney SE, Naraghi A, Salonen D, Theodoropoulos J, White LM. Hip and groin pain in the professional athlete. Can Assoc Radiol J. 2012;63(2):87–99.CrossRef McSweeney SE, Naraghi A, Salonen D, Theodoropoulos J, White LM. Hip and groin pain in the professional athlete. Can Assoc Radiol J. 2012;63(2):87–99.CrossRef
8.
Zurück zum Zitat Zoga AC, Kavanagh EC, Omar IM, Morrison WB, Koulouris G, Lopez H, et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology. 2008;247(3):797–807.CrossRef Zoga AC, Kavanagh EC, Omar IM, Morrison WB, Koulouris G, Lopez H, et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology. 2008;247(3):797–807.CrossRef
9.
Zurück zum Zitat Omar IM, Zoga AC, Kavanagh EC, Koulouris G, Bergin D, Gopez AG, et al. Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings. Radiographics. 2008;28(5):1415–38.CrossRef Omar IM, Zoga AC, Kavanagh EC, Koulouris G, Bergin D, Gopez AG, et al. Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings. Radiographics. 2008;28(5):1415–38.CrossRef
10.
Zurück zum Zitat Birmingham PM, Kelly BT, 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.CrossRef Birmingham PM, Kelly BT, 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.CrossRef
11.
Zurück zum Zitat Larson CM, Pierce BR, Giveans MR. Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series. Arthroscopy. 2011;27(6):768–75.CrossRef Larson CM, Pierce BR, Giveans MR. Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series. Arthroscopy. 2011;27(6):768–75.CrossRef
12.
Zurück zum Zitat Saito M, Utsunomiya H, Hatakeyama A, Nakashima H, Nishimura H, Matsuda DK, et al. Hip arthroscopic management can improve osteitis pubis and bone marrow edema in competitive soccer players with femoroacetabular impingement. Am J Sports Med. 2019;47(2):408–19.CrossRef Saito M, Utsunomiya H, Hatakeyama A, Nakashima H, Nishimura H, Matsuda DK, et al. Hip arthroscopic management can improve osteitis pubis and bone marrow edema in competitive soccer players with femoroacetabular impingement. Am J Sports Med. 2019;47(2):408–19.CrossRef
13.
Zurück zum Zitat Sansone M, Ahldén M, Jonasson P, Thomeé R, Falk A, Swärd L, et al. Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):786–92.CrossRef Sansone M, Ahldén M, Jonasson P, Thomeé R, Falk A, Swärd L, et al. Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):786–92.CrossRef
14.
Zurück zum Zitat Munegato D, Bigoni M, Gridavilla G, Olmi S, Cesana G, Zatti G. Sports hernia and femoroacetabular impingement in athletes: a systematic review. World J Clin Cases. 2015;3(9):823–30.CrossRef Munegato D, Bigoni M, Gridavilla G, Olmi S, Cesana G, Zatti G. Sports hernia and femoroacetabular impingement in athletes: a systematic review. World J Clin Cases. 2015;3(9):823–30.CrossRef
15.
Zurück zum Zitat Nötzli 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 Joint Surg Br. 2002;84(4):556–60.CrossRef Nötzli 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 Joint Surg Br. 2002;84(4):556–60.CrossRef
16.
Zurück zum Zitat Tallroth K, Lepistö J. Computed tomography measurement of acetabular dimensions: normal values for correction of dysplasia. Acta Orthop. 2006;77(4):598–602.CrossRef Tallroth K, Lepistö J. Computed tomography measurement of acetabular dimensions: normal values for correction of dysplasia. Acta Orthop. 2006;77(4):598–602.CrossRef
18.
Zurück zum Zitat Anda S, Terjesen T, Kvistad KA. Computed tomography measurements of the acetabulum in adult dysplastic hips: which level is appropriate? Skelet Radiol. 1991;20(4):267–71.CrossRef Anda S, Terjesen T, Kvistad KA. Computed tomography measurements of the acetabulum in adult dysplastic hips: which level is appropriate? Skelet Radiol. 1991;20(4):267–71.CrossRef
19.
Zurück zum Zitat Brennan D, O’Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, et al. Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology. 2005;235(1):162–7.CrossRef Brennan D, O’Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, et al. Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology. 2005;235(1):162–7.CrossRef
20.
Zurück zum Zitat Hammoud S, Bedi A, Magennis E, Meyers WC, Kelly BT. High incidence of athletic pubalgia symptoms in professional athletes with symptomatic femoroacetabular impingement. Arthroscopy. 2012;28(10):1388–95.CrossRef Hammoud S, Bedi A, Magennis E, Meyers WC, Kelly BT. High incidence of athletic pubalgia symptoms in professional athletes with symptomatic femoroacetabular impingement. Arthroscopy. 2012;28(10):1388–95.CrossRef
21.
Zurück zum Zitat Larson CM, Sikka RS, Sardelli MC, Byrd JWT, Kelly BT, Jain RK, et al. Increasing alpha angle is predictive of athletic-related “hip” and “groin” pain in collegiate National Football League prospects. Arthroscopy. 2013;29(3):405–10.CrossRef Larson CM, Sikka RS, Sardelli MC, Byrd JWT, Kelly BT, Jain RK, et al. Increasing alpha angle is predictive of athletic-related “hip” and “groin” pain in collegiate National Football League prospects. Arthroscopy. 2013;29(3):405–10.CrossRef
22.
Zurück zum Zitat Verrall GM, Slavotinek JP, Barnes PG, Esterman A, Oakeshott RD, Spriggins AJ. Hip joint range of motion restriction precedes athletic chronic groin injury. J Sci Med Sport. 2007;10(6):463–6.CrossRef Verrall GM, Slavotinek JP, Barnes PG, Esterman A, Oakeshott RD, Spriggins AJ. Hip joint range of motion restriction precedes athletic chronic groin injury. J Sci Med Sport. 2007;10(6):463–6.CrossRef
23.
Zurück zum Zitat Verrall GM, Hamilton IA, Slavotinek JP, Oakeshott RD, Spriggins AJ, Barnes PG, et al. 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.CrossRef Verrall GM, Hamilton IA, Slavotinek JP, Oakeshott RD, Spriggins AJ, Barnes PG, et al. 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.CrossRef
24.
Zurück zum Zitat Weir A, de Vos RJ, Moen M, Hölmich P, Tol JL. Prevalence of radiological signs of femoroacetabular impingement in patients presenting with long-standing adductor-related groin pain. Br J Sports Med. 2011;45(1):6–9.CrossRef Weir A, de Vos RJ, Moen M, Hölmich P, Tol JL. Prevalence of radiological signs of femoroacetabular impingement in patients presenting with long-standing adductor-related groin pain. Br J Sports Med. 2011;45(1):6–9.CrossRef
25.
Zurück zum Zitat Feeley BT, Powell JW, Muller MS, Barnes RP, Warren RF, Kelly BT. Hip injuries and labral tears in the national football league. Am J Sports Med. 2008;36(11):2187–95.CrossRef Feeley BT, Powell JW, Muller MS, Barnes RP, Warren RF, Kelly BT. Hip injuries and labral tears in the national football league. Am J Sports Med. 2008;36(11):2187–95.CrossRef
26.
Zurück zum Zitat Kavroudakis E, Karampinas PK, Evangelopoulos DS, Vlamis J. Treatment of osteitis pubis in non-athlete female patients. Open Orthop J. 2011;5:331–4.CrossRef Kavroudakis E, Karampinas PK, Evangelopoulos DS, Vlamis J. Treatment of osteitis pubis in non-athlete female patients. Open Orthop J. 2011;5:331–4.CrossRef
27.
Zurück zum Zitat Angoules AG. Osteitis pubis in elite athletes: diagnostic and therapeutic approach. World J Orthop. 2015;6(9):672–9.CrossRef Angoules AG. Osteitis pubis in elite athletes: diagnostic and therapeutic approach. World J Orthop. 2015;6(9):672–9.CrossRef
28.
Zurück zum Zitat Kennedy MJ, Lamontagne M, Beaulé PE. Femoroacetabular impingement alters hip and pelvic biomechanics during gait walking biomechanics of FAI. Gait Posture. 2009;30(1):41–4.CrossRef Kennedy MJ, Lamontagne M, Beaulé PE. Femoroacetabular impingement alters hip and pelvic biomechanics during gait walking biomechanics of FAI. Gait Posture. 2009;30(1):41–4.CrossRef
29.
Zurück zum Zitat Hammoud S, Bedi A, Voos JE, Mauro CS, Kelly BT. The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain. Sports Health. 2014;6(2):108–18.CrossRef Hammoud S, Bedi A, Voos JE, Mauro CS, Kelly BT. The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain. Sports Health. 2014;6(2):108–18.CrossRef
Metadaten
Titel
The prevalence of athletic pubalgia imaging findings on MRI in patients with femoroacetabular impingement
verfasst von
Sowmya Varada
Matthew P. Moy
Fangbai Wu
Michael J. Rasiej
Diego Jaramillo
Tony T. Wong
Publikationsdatum
06.03.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 8/2020
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-020-03405-z

Weitere Artikel der Ausgabe 8/2020

Skeletal Radiology 8/2020 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.