Summary about Disease
Hip impingement, also known as femoroacetabular impingement (FAI), is a condition where there is abnormal contact between the bones in the hip joint. Specifically, the femoral head (the ball at the top of the thighbone) and the acetabulum (the socket in the pelvis) rub against each other, leading to damage to the cartilage (labrum) and the bone over time. This friction can cause pain, stiffness, and limited range of motion in the hip. There are three types: pincer, cam, and combined. Pincer impingement occurs when the acetabulum has too much coverage. Cam impingement occurs when the femoral head is not round.
Symptoms
Pain in the groin area, often described as a deep ache.
Pain that may radiate to the side, front, or back of the hip.
Stiffness in the hip joint.
Limited range of motion, especially with internal rotation (turning the leg inward).
Clicking, catching, or locking sensation in the hip.
Pain that worsens with activity, prolonged sitting, or pivoting movements.
Limping.
Causes
Abnormal bone shapes: This is the primary cause. Either the femoral head is not perfectly round (cam impingement) or the acetabulum has excessive coverage (pincer impingement), or a combination of both.
Genetic predisposition: Some people may be more likely to develop FAI due to inherited bone structure.
Childhood hip conditions: Conditions like Legg-Calve-Perthes disease or slipped capital femoral epiphysis can alter hip joint development and lead to FAI.
Repetitive hip motions: Certain activities or sports involving repetitive hip flexion and rotation may contribute to the development of FAI over time.
Medicine Used
Pain relievers: Over-the-counter medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation.
Prescription pain medications: In more severe cases, a doctor may prescribe stronger pain relievers, such as opioids, for short-term use.
Corticosteroid injections: Corticosteroids can be injected into the hip joint to reduce inflammation and pain. These injections provide temporary relief but do not address the underlying structural problem.
Viscosupplementation: Hyaluronic acid injections can be used to lubricate the joint.
Is Communicable
Hip impingement is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Maintain a healthy weight: Excess weight can put additional stress on the hip joint.
Avoid activities that aggravate your pain: Modify or avoid activities that cause pain or discomfort in the hip.
Proper warm-up and stretching: Before engaging in physical activity, warm up your muscles and stretch your hip flexors, hamstrings, and groin muscles.
Use proper form during exercise: Ensure you are using correct technique to avoid placing undue stress on the hip joint.
Strengthen hip muscles: Strengthening the muscles around the hip joint can help provide support and stability.
See a doctor if you experience hip pain: Early diagnosis and treatment can help prevent further damage to the hip joint.
How long does an outbreak last?
Hip impingement is not an outbreak. Symptoms can persist for months or years if left untreated. The duration of symptoms varies widely depending on the severity of the impingement, the level of activity, and the effectiveness of treatment.
How is it diagnosed?
Physical examination: A doctor will assess your range of motion, hip stability, and palpate the hip joint to identify areas of tenderness. Specific impingement tests, such as the FADDIR test (Flexion, Adduction, Internal Rotation), may be performed.
X-rays: X-rays can reveal structural abnormalities in the hip joint, such as a cam deformity or pincer impingement.
MRI: Magnetic resonance imaging (MRI) provides detailed images of the soft tissues in the hip, including the labrum and cartilage. This can help identify labral tears or cartilage damage.
CT scan: A computed tomography (CT) scan provides detailed cross-sectional images of the bones in the hip joint.
Diagnostic injection: An injection of a local anesthetic into the hip joint can help determine if the pain is originating from the hip.
Timeline of Symptoms
The timeline of symptoms can vary.
Early Stages: Mild, intermittent groin pain, often occurring after activity. Limited range of motion may be subtle.
Progression: Pain becomes more frequent and intense, occurring with less activity. Stiffness increases, and range of motion is more limited. Clicking or catching sensations may develop.
Advanced Stages: Constant pain, even at rest. Significant limitations in range of motion, making activities like walking, sitting, and climbing stairs difficult. Development of arthritis in the hip joint.
Important Considerations
Early diagnosis is crucial: Prompt diagnosis and treatment can help prevent further damage to the hip joint and delay or avoid the need for surgery.
Non-operative treatment: Physical therapy, activity modification, and pain management are important components of non-operative treatment.
Surgery: Arthroscopic hip surgery may be recommended if non-operative treatments are not effective. The goal of surgery is to reshape the bone and repair any damage to the labrum or cartilage.
Long-term management: Even after successful treatment, ongoing management may be necessary to prevent recurrence and maintain hip function.
Individualized treatment: Treatment plans should be tailored to the individual's specific needs and goals.