What is hip impingement?
The medical term most commonly used is femoroacetabular impingement, which is the relationship between the acetabular rim and proximal femur.
Who will be at risk?
It is a common cause of hip pain and is found in athletes, adolescents and adults. It injures the labrum and articular cartilage and can lead to osteoarthritis of the hip.
Symptoms
Patients with hip impingement, typically have hip pain in the front and outside (antero lateral). They often cup the hip with the thumb and fore finger in the shape of a C. Pain is sharp when turning or pivoting, especially in the affected area. It can worsen with prolonged sitting and getting in and out of a car. Pain is usually gradual and progressive.
Diagnosis
Physical examination is the first step, specifically moving the affected hip into flexion, adduction and internal rotation (fadir) and getting a positive response. Diagnostic testing usually takes the form of an x-ray, but care should be taken that the hip is in flexion 90° and adduction 20° to increase the chance of identifying any lesions and osteophytes. It is also quite possible that an MRI will also be taken with the extra steps including a local anaesthetic. Of particular interest will be to determine if there is a labrum tear.
Treatment
There is no real evidence than non-surgical treatment has any lasting benefit. Certainly a course of manual therapy and chiropractic would be advisable, partly to treat the effects of the hip impingement or other structures.
Referral to an orthopaedic consultant will involve an arthroscopy, designed to alleviate the impingement, to repair or remove injured tissue and to prevent or delay osteoarthritis. Success rates seemed to range from 75-84%.
Source – GS Kuhlman and BG Domb 2009 American Family Physician