Diagnostic Ultrasound for Hip Impingement

Diagnostic Ultrasound for Hip Impingement

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Femoroacetabular impingement (FAI), also called hip impingement, occurs when the ball-shaped femoral head repetitively contacts the hip acetabulum abnormally causing pain and leading to osteoarthritis. An early diagnosis of FAI is needed for effective management but is often diagnosed when symptoms and osteoarthritis are already present. 

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Doctors use several imaging tests to diagnose FAI along with a physical exam. Imaging tests can include xrays, MRIs, and more recently, ultrasound. Ultrasound imaging is a safe and noninvasive way to detect local cartilage defects, cartilage lesions, and lesions of the labrum. Lesions of the labrum are typically observed on imaging in patients that have FAI. Ultrasound is also known to be able to detect small osteophytes which are radiologically features of osteoarthritis, a diagnosis that can worsen the overall prognosis of patients with FAI. 

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A study looking at ultrasound's ability to detect abnormalities was conducted with forty-four patients with clinical signs and radiographic features of FAI absent of osteoarthritis. Ultrasound changes were found in 93.2% of patients, with 63.6% showing some kind of labral abnormality, 40.9% showing articular cartilage abnormalities, 38.6% showing bone contour irregularities, and 29.5% showing osteophytes. These findings demonstrate that ultrasound can be a useful, nonaggressive, and inexpensive available technique that can play an effective role in evaluation of patients in early stages of FAI. 

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Orellana C, Moreno M, Calvet J, Navarro N, García-Manrique M, Gratacós J. Ultrasound Findings in Patients With Femoracetabular Impingement Without Radiographic Osteoarthritis: A Pilot Study. J Ultrasound Med. 2019;38(4):895-901. doi:10.1002/jum.14768

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