Learning objectives
The authors want to demonstrate the importance of a correct radiography projection for the femoroacetabular impingement. Femoroacetabular impingement diagnosis is made by physical evaluation of the patient and supported by radiology.
To the initial imaging protocol,
AP weight bearing projection of pelvis and Dunn,
sometimes CT and MRI were needed,
in order to fill some unclear information from the radiographs. The authors choose an intermediate projection between modified Dunn and Lowenstein...
Background
Femoroacetabular impingement is a recent studied pathology,
which was first described in 2003. It is a condition in which extra bone grows along one or both hip joint,
giving an irregular shape,
resulting overtime in pain and limiting the articular range of the joint,
it could lead to tears of the labrum and later,
breakdown of articular cartilage (osteoarthritis). Some causes of femoroacetabular impingement can be related to sports activity when they repeat continuously internal hip rotation...
Findings and procedure details
The radiographs protocol consists in AP weight bearing of pelvis and modified Dunn which is the prefered projection for the authors. Consists in patient supine with pelvis in neutral rotation,then the hip is flexed 90° and abducted 20°,
while pelvis remains in neutral rotation.
The centering point is the midpoint between the anterior superior iliac spine and the pubic symphysis,angulated 10º cephalic. The collimation is laterally to proximal third of femur,
superiorly to anterior superior...
Conclusion
The correct choice of a radiograph projection for femoroacetabular impingement diagnosis is essential,
dismissing most of times,
all other expensive and complex radiologic modalities,
such as CT scan and MRI,
saving time,
money and radiation dosage to the patient.
This imaging modalities are used only to characterize subtle cases of femoroacetabular impingement and other causes of pain and arthro MRI is indicated when there are suspicions of labral or chondral lesions. . The author’s modified...
Personal information
Contact details: Centro Hospitalar Cova da Beira ( www.chcbeira.pt ) Richard Lopes Radiographer in Centro Hospitalar Cova da Beira Email: 96.richard@gmail.com Centro Hospitalar do Porto ( www.chporto.pt ) Filipe Oliveira Radiographer in Centro Hospitalar do Porto Artur Ribeiro Radiographer in Centro Hospitalar do Porto Email: artur64@gmail.com Centro Hospitalar Lisboa Norte ( www.chln.pt ) Ana Monteiro Radiographer in Centro Hospitalar Lisboa Norte Email: anara.monteiro@gmail.com
References
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What Are the Radiographic Reference Values for Acetabular Under- and Overcoverage?,2015,Clin Orthop Relat ,473:1234–1246 Banerjee,
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