Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 10/2016

12.07.2016 | Arthroscopy and Sports Medicine

Ultrasound is as reliable as plain radiographs in the diagnosis of cam-type femoroacetabular impingement

verfasst von: Solveig Lerch, Andreas Kasperczyk, Thomas Berndt, Oliver Rühmann

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 10/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

In the diagnosis of femoroacetabular impingement (FAI), plain radiographs are accepted as the initial imaging method. However, there is no consensus regarding the optimal lateral view, and radiographs can underestimate the asphericity of the head–neck junction. Our research question was if ultrasound has at least the same reliability as X-ray and can be used as an alternative or additional method in the initial imaging of FAI.

Materials and methods

Forty patients with a median age of 39 years were consecutively included after diagnosis of cam-type FAI on magnetic resonance imaging (MRI). All patients underwent radiography involving a plain anteroposterior-view, frog-leg lateral view, and ultrasound of the hip joint in the ventral longitudinal section at 20° internal rotation. Parameters measured by MRI, radiographs, and ultrasound were the alpha angle, anterior offset, offset ratio, and anterior femoral distance.

Results

No significant difference between the alpha angle on MRI (64.8°), the frog-leg view (66.3°), or ultrasound (65.6°) could be detected. Comparable correlation was found between the alpha angle on MRI and the frog-leg lateral view (r = 0.73; p < 0.0001) and between the alpha angle on MRI and sonograms (r = 0.77; p < 0.0001). The intra-class correlation coefficient for measurements using ultrasound was 0.81–0.98, and using radiographs was 0.83–0.99, with the exception of measurements involving the anterior offset on the frog-leg lateral view (0.61 and 0.64).

Conclusions

Ultrasound is as reliable as plain radiographs in the diagnosis of cam-type FAI and can serve as an alternative or additional method in initial imaging.
Literatur
1.
Zurück zum Zitat Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417(417):112–120PubMed Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417(417):112–120PubMed
2.
Zurück zum Zitat Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res 213(213):20–33PubMed Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res 213(213):20–33PubMed
3.
Zurück zum Zitat Tanzer M, Noiseux N (2004) Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res 429:170–177CrossRefPubMed Tanzer M, Noiseux N (2004) Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res 429:170–177CrossRefPubMed
4.
Zurück zum Zitat Barton C, Salineros MJ, Rakhra KS, Beaule PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469CrossRefPubMed Barton C, Salineros MJ, Rakhra KS, Beaule PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469(2):464–469CrossRefPubMed
5.
Zurück zum Zitat Cavaignac E, Chiron P, Espie A, Reina N, Lepage B, Laffosse JM (2012) Experimental study of an original radiographic view for diagnosis of cam-type anterior femoroacetabular impingement. Int Orthop 36(9):1783–1788CrossRefPubMedPubMedCentral Cavaignac E, Chiron P, Espie A, Reina N, Lepage B, Laffosse JM (2012) Experimental study of an original radiographic view for diagnosis of cam-type anterior femoroacetabular impingement. Int Orthop 36(9):1783–1788CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Domayer SE, Ziebarth K, Chan J, Bixby S, Mamisch TC, Kim YJ (2011) Femoroacetabular cam-type impingement: diagnostic sensitivity and specificity of radiographic views compared to radial MRI. Eur J Radiol 80(3):805–810CrossRefPubMed Domayer SE, Ziebarth K, Chan J, Bixby S, Mamisch TC, Kim YJ (2011) Femoroacetabular cam-type impingement: diagnostic sensitivity and specificity of radiographic views compared to radial MRI. Eur J Radiol 80(3):805–810CrossRefPubMed
7.
Zurück zum Zitat Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res 445:181–185PubMed Meyer DC, Beck M, Ellis T, Ganz R, Leunig M (2006) Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res 445:181–185PubMed
8.
Zurück zum Zitat Nepple JJ, Martel JM, Kim YJ, Zaltz I, Clohisy JC (2012) Do plain radiographs correlate with CT for imaging of cam-type femoroacetabular impingement? Clin Orthop Relat Res 470(12):3313–3320CrossRefPubMedPubMedCentral Nepple JJ, Martel JM, Kim YJ, Zaltz I, Clohisy JC (2012) Do plain radiographs correlate with CT for imaging of cam-type femoroacetabular impingement? Clin Orthop Relat Res 470(12):3313–3320CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Harris MD, Kapron AL, Peters CL, Anderson AE (2014) Correlations between the alpha angle and femoral head asphericity: implications and recommendations for the diagnosis of cam femoroacetabular impingement. Eur J Radiol 83(5):788–796CrossRefPubMedPubMedCentral Harris MD, Kapron AL, Peters CL, Anderson AE (2014) Correlations between the alpha angle and femoral head asphericity: implications and recommendations for the diagnosis of cam femoroacetabular impingement. Eur J Radiol 83(5):788–796CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Konan S, Rayan F, Haddad FS (2010) Is the frog lateral plain radiograph a reliable predictor of the alpha angle in femoroacetabular impingement? J Bone Joint Surg Br 92(1):47–50CrossRefPubMed Konan S, Rayan F, Haddad FS (2010) Is the frog lateral plain radiograph a reliable predictor of the alpha angle in femoroacetabular impingement? J Bone Joint Surg Br 92(1):47–50CrossRefPubMed
11.
Zurück zum Zitat Clohisy JC, Carlisle JC, Trousdale R, Kim YJ, Beaule PE, Morgan P et al (2009) Radiographic evaluation of the hip has limited reliability. Clin Orthop Relat Res 467(3):666–675CrossRefPubMed Clohisy JC, Carlisle JC, Trousdale R, Kim YJ, Beaule PE, Morgan P et al (2009) Radiographic evaluation of the hip has limited reliability. Clin Orthop Relat Res 467(3):666–675CrossRefPubMed
12.
Zurück zum Zitat Dudda M, Albers C, Mamisch TC, Werlen S, Beck M (2009) Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res 467(3):651–659CrossRefPubMed Dudda M, Albers C, Mamisch TC, Werlen S, Beck M (2009) Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res 467(3):651–659CrossRefPubMed
13.
Zurück zum Zitat Kusma M, Bachelier F, Schneider G, Dienst M (2009) Femoroacetabular impingement. Clinical and radiological diagnostics. Orthopade 38(5):402–411CrossRefPubMed Kusma M, Bachelier F, Schneider G, Dienst M (2009) Femoroacetabular impingement. Clinical and radiological diagnostics. Orthopade 38(5):402–411CrossRefPubMed
14.
Zurück zum Zitat Mamisch TC, Werlen S, Zilkens C, Trattnig S, Kim YJ, Siebenrock KA et al (2009) Radiological diagnosis of femoroacetabular impingement. Radiologe 49(5):425–433CrossRefPubMed Mamisch TC, Werlen S, Zilkens C, Trattnig S, Kim YJ, Siebenrock KA et al (2009) Radiological diagnosis of femoroacetabular impingement. Radiologe 49(5):425–433CrossRefPubMed
15.
Zurück zum Zitat Lerch S, Kasperczyk A, Warnecke J, Berndt T, Ruhmann O (2013) Evaluation of cam-type femoroacetabular impingement by ultrasound. Int Orthop 37(5):783–788CrossRefPubMedPubMedCentral Lerch S, Kasperczyk A, Warnecke J, Berndt T, Ruhmann O (2013) Evaluation of cam-type femoroacetabular impingement by ultrasound. Int Orthop 37(5):783–788CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ et al (2008) A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am 90(Suppl 4):47–66CrossRefPubMedPubMedCentral Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ et al (2008) A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am 90(Suppl 4):47–66CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Jt Surg Br 84(4):556–560CrossRef Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Jt Surg Br 84(4):556–560CrossRef
18.
Zurück zum Zitat Eijer H, Leunig M, Mahomed MN, Ganz R (2001) Cross-table lateral radiographs for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip Int 11(1):37–41 Eijer H, Leunig M, Mahomed MN, Ganz R (2001) Cross-table lateral radiographs for screening of anterior femoral head-neck offset in patients with femoro-acetabular impingement. Hip Int 11(1):37–41
19.
Zurück zum Zitat Lohan DG, Seeger LL, Motamedi K, Hame S, Sayre J (2009) Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer? Skeletal Radiol 38(9):855–862CrossRefPubMed Lohan DG, Seeger LL, Motamedi K, Hame S, Sayre J (2009) Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer? Skeletal Radiol 38(9):855–862CrossRefPubMed
20.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMed
21.
Zurück zum Zitat Clohisy JC, Nunley RM, Otto RJ, Schoenecker PL (2007) The frog-leg lateral radiograph accurately visualized hip cam impingement abnormalities. Clin Orthop Relat Res 462:115–121CrossRefPubMed Clohisy JC, Nunley RM, Otto RJ, Schoenecker PL (2007) The frog-leg lateral radiograph accurately visualized hip cam impingement abnormalities. Clin Orthop Relat Res 462:115–121CrossRefPubMed
22.
Zurück zum Zitat Beck M, Kalhor M, Leunig M, Ganz R (2005) 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 87(7):1012–1018CrossRef Beck M, Kalhor M, Leunig M, Ganz R (2005) 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 87(7):1012–1018CrossRef
23.
Zurück zum Zitat Buck FM, Hodler J, Zanetti M, Dora C, Pfirrmann CW (2011) Ultrasound for the evaluation of femoroacetabular impingement of the cam type. Diagnostic performance of qualitative criteria and alpha angle measurements. Eur Radiol 21(1):167–175CrossRefPubMed Buck FM, Hodler J, Zanetti M, Dora C, Pfirrmann CW (2011) Ultrasound for the evaluation of femoroacetabular impingement of the cam type. Diagnostic performance of qualitative criteria and alpha angle measurements. Eur Radiol 21(1):167–175CrossRefPubMed
24.
Zurück zum Zitat Rakhra KS, Sheikh AM, Allen D, Beaule PE (2009) Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res 467(3):660–665CrossRefPubMed Rakhra KS, Sheikh AM, Allen D, Beaule PE (2009) Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res 467(3):660–665CrossRefPubMed
25.
Zurück zum Zitat Espie A, Chaput B, Murgier J, Bayle-Iniguez X, Elia F, Chiron P (2014) 45 degrees −45 degrees −30 degrees Frog-leg radiograph for diagnosing cam-type anterior femoroacetabular impingement: reproducibility and thresholds. Orthop Traumatol Surg Res 100(8):843–848CrossRefPubMed Espie A, Chaput B, Murgier J, Bayle-Iniguez X, Elia F, Chiron P (2014) 45 degrees −45 degrees −30 degrees Frog-leg radiograph for diagnosing cam-type anterior femoroacetabular impingement: reproducibility and thresholds. Orthop Traumatol Surg Res 100(8):843–848CrossRefPubMed
Metadaten
Titel
Ultrasound is as reliable as plain radiographs in the diagnosis of cam-type femoroacetabular impingement
verfasst von
Solveig Lerch
Andreas Kasperczyk
Thomas Berndt
Oliver Rühmann
Publikationsdatum
12.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 10/2016
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2509-6

Weitere Artikel der Ausgabe 10/2016

Archives of Orthopaedic and Trauma Surgery 10/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

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