Femoroacetabular Impingement: Assessment, Treatment & Outcome

Femoroacetabular impingement (FAI) is a condition resulting from morphologic abnormalities of the acetabular rim and proximal femur. The pathomechanics of FAI leads to abnormal contact between the acetabular rim and femoral head-neck junction, creating chondral lesions, labral pathology and secondary degenerative joint disease (DJD). Recent investigation has indicated that FAI might be the underlying etiology in most DJD cases that were previously identified as “idiopathic”. 

Many patients with symptomatic FAI experience delays in diagnosis, incorrect diagnosis, and ineffective treatment recommendations. FAI is often misdiagnosed and mismanaged as groin strain, early osteoarthritis, inguinal hernia or a low back disorder. However, recently it has been hypothesized that conditions including osteitis pubis, sports hernia, inflammation of the sacro-iliac joint (SIJ), adductor strain, rectus femoris strain, and posterior hip (medical) subluxation may in part be caused by compensatory stresses due to FAI. 

FAI is now a well-documented cause of pain, dysfunction and premature degenerative changes of the hips in the athletic population. The chiropractic profession needs to increase their awareness of FAI, as they are often the primary contact for patients presenting with this disorder. Consequently, it is essential that chiropractic practitioners are familiar with the assessment, diagnosis and management of this condition. 

 

Presentation Outline

10 min – Course objectives, morphological abnormalities and pathomechanics of FAI

20 min - Clinical presentation, physical examination and radiographic features of FAI

20 min – treatment options and the role of the chiropractor in the management of FAI

10 min – Conclusions, Q & A