Association of clinical and radiographic signs of femoroacetabular impingement in the general population

Background: The relationships between the clinical and radiographic signs of femoroacetabular impingement (FAI) are unknown. The purpose of this study was to assess the relationship between hip pain, a positive anterior impingement sign (AIS), and radiographic signs of FAI in a general Japanese population. Methods: A total of 616 individuals participated in this study. Hip pain was assessed using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire UHEQ) pain category score and the AIS was used as a provocation test. Participants were divided into a positive AIS group (at least one positive hip) and a negative AIS group. Radiographs were assessed for the cross-over sign (COS), ischial spine sign (ISS), posterior wall sign (PWS), and pistol grip deformity (PGD). Then, the relationships between the clinical and radiographic signs of FAI were evaluated. Results: JHEQ pain scores did not differ between men and women. Seven men (3.4%) and 29 women (7.1%) had a least one hip with a positive AIS. The mean JHEQ pain scores were 22.9 +/- 7.2 for the positive and 27.3 +/- 2.2 for the negative AIS group (P < 0.01). The prevalences of COS, ISS, PWS, and PGD were 8.9%, 17.2%, 21.8%, and 1.9%, respectively. There were no significant associations between degree of hip pain, AIS, and each radiographic finding. Conclusions: Radiographic signs of FAI were not associated with the degree of hip pain or a positive AIS, which suggests that radiographic findings may not be important in the clinical diagnosis of FAI. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.