Best Practice Case Studies-Case 134 Asset 5 Femoroacetabular Impingement (FAI) and Hip Pain

Video Transcription

Video Summary

The lecture focused on femoroacetabular impingement (FAI), especially cam deformities, in athletes and active patients. Dr. Benedict Wanchukwu explained that hip pain is no longer viewed as simply arthritis versus no arthritis; instead, clinicians must consider multiple causes of anterior, lateral, and posterior hip pain, including dysplasia, subspine impingement, sports hernia, trochanteric bursitis, gluteal tears, hamstring injuries, and spine-related pain.<br /><br />He described how FAI can affect not only the hip joint but also the spine and knee, contributing to back pain and increasing ACL injury risk due to altered mechanics. Clinical evaluation should include history, gait, palpation, range of motion, and provocative tests such as FADIR, FABER, subspine, and posterior rim impingement tests. Imaging begins with AP pelvis and lateral hip X-rays, followed by MRI and occasionally CT to assess labrum, cartilage, bone edema, version, and alternative diagnoses.<br /><br />Diagnostic and therapeutic injections can help confirm intra-articular pain and guide treatment. Conservative management should include at least three months of physical therapy, with focus on gluteal and core deficits. Surgery is considered for persistent symptoms, significant cam deformity, or cartilage damage. He emphasized that successful arthroscopy depends on proper diagnosis and patient selection. The session ended with case-based questions and discussion.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 134

Topic Hip

Keywords

4th Edition

4th Edition, Case 134

Hip

femoroacetabular impingement

cam deformity

hip pain

athletes

FADIR test

hip arthroscopy

labral tear

physical therapy

diagnostic injections