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Femoroacetabular impingement - cam-type

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Hip pain.

Patient Data

Age: 20
Gender: Male

There is asphericity of the femoral head/neck junction, with a bony bump / cam lesion anterosuperiorly. There is very minor underlying subcortical marrow edema in this region, suggestive of bony abutment.

Alpha angle is 55 degrees (oblique axial plane). Center-edge angle is 40 degrees, which is suggestive of borderline over- coverage.

There is a partial thickness tear of the anterior and superior labrum, with chondro-labral separation extending from the 2 o'clock position anteriorly to approximately the 10-11 o'clock position posteriorly. The ligamentum teres is intact. The iliopsoas tendon is unremarkable. Gluteal minimus and medius tendons are also unremarkable. No trochanteric bursitis.

Conclusion: There is a cam lesion, and borderline acetabular overcoverage, with an associated anterior and superolateral chondrolabral separation.

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