Summary about Disease
Femoroacetabular impingement (FAI) is a condition where abnormal bone growth in the hip joint (either on the femur, acetabulum, or both) causes the bones to rub against each other during movement. This abnormal contact can damage the cartilage (labrum and articular cartilage) and lead to pain, stiffness, and eventually osteoarthritis. There are three types: Cam impingement (extra bone on the femur), Pincer impingement (extra bone on the acetabulum), and Mixed impingement (both Cam and Pincer).
Symptoms
Symptoms of FAI can vary but often include:
Pain in the groin area (most common).
Pain in the buttock or outer hip.
Stiffness in the hip joint.
Limited range of motion, especially with hip flexion (bending the hip) and internal rotation.
Clicking, catching, or locking sensation in the hip.
Pain that worsens with activity, prolonged sitting, or specific movements.
Causes
FAI is caused by abnormal bone growth around the hip joint during childhood or adolescence. The exact cause of this abnormal growth is not fully understood, but factors may include:
Genetics/Heredity.
Childhood activity levels.
Certain medical conditions.
Repetitive hip movements during growth.
Medicine Used
Medications are used to manage the symptoms of FAI, not to correct the underlying bone abnormality. Common medications include:
Pain relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to reduce pain and inflammation.
Corticosteroid injections: Corticosteroids can be injected into the hip joint to reduce inflammation and pain. These injections are typically used for temporary relief.
Viscosupplementation: Hyaluronic acid injections to improve joint lubrication
Is Communicable
FAI is not a communicable disease. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
While you cannot prevent FAI from developing, you can take precautions to manage symptoms and slow progression:
Avoid activities that exacerbate pain: Modify or avoid activities that worsen your hip pain.
Maintain a healthy weight: Excess weight puts extra stress on the hip joint.
Strengthen hip and core muscles: Strong muscles help stabilize the hip and improve joint mechanics.
Proper warm-up and stretching: Prepare your body for activity with proper warm-up routines and stretches.
Consult a physical therapist: A physical therapist can provide exercises and strategies to manage pain and improve function.
Avoid repetitive hip motions: In growing children, avoid highly repetitive hip motions
How long does an outbreak last?
FAI is not an "outbreak" condition. It's a chronic condition related to bone growth and joint mechanics. Symptoms can be intermittent, fluctuating in intensity depending on activity level and other factors. If left unmanaged, the condition can progress and lead to chronic pain and osteoarthritis.
How is it diagnosed?
FAI is diagnosed through a combination of:
Medical history and physical examination: The doctor will ask about your symptoms, activity level, and medical history, and perform a physical exam to assess your hip's range of motion and identify areas of pain.
Imaging studies:
X-rays: To visualize the bones of the hip joint and identify any abnormalities, such as Cam or Pincer deformities.
MRI (magnetic resonance imaging): To evaluate the soft tissues around the hip joint, including the labrum and articular cartilage, and identify any tears or damage.
CT scan (computed tomography): Can be used to further assess the bony anatomy of the hip.
Diagnostic injection: An injection of local anesthetic into the hip joint can help determine if the pain is originating from within the joint.
Timeline of Symptoms
The timeline of symptoms can vary widely from person to person. Some individuals may experience mild symptoms for years, while others may develop more severe pain relatively quickly.
Early stages: Mild pain or stiffness that may only occur with certain activities.
Progression: Pain may become more frequent and intense, and may occur with everyday activities.
Advanced stages: Chronic pain, limited range of motion, and possible development of osteoarthritis. The timeline for progression depends on individual factors such as activity level, the severity of the impingement, and the presence of other joint problems.
Important Considerations
Early diagnosis and treatment are important to prevent further damage to the hip joint and delay the onset of osteoarthritis.
Non-surgical treatments, such as physical therapy and pain management, may be effective for some individuals.
Hip arthroscopy (minimally invasive surgery) is often recommended for individuals with persistent pain and significant limitations in function. Surgery aims to reshape the bone and repair any damage to the labrum or cartilage.
Not everyone with FAI requires surgery. The decision to undergo surgery should be made in consultation with an orthopedic surgeon after considering the severity of symptoms and the impact on daily life.
Even after surgery, rehabilitation and lifestyle modifications are important for long-term success.