A ball and socket joint, the hip joint consists of the acetabulum and femoral head. The femoral head fits into the acetabulum and can glide in many different directions, making it one of the most mobile joints. The rim of the joint consists of a piece of cartilage called the labrum, which locks the femoral head in the socket. A typically smooth moving joint, the hip joint can experience hip impingement or femoro acetabular impingement syndrome causing painful and catching movements. Hip impingement can potentially damage the joint, leading to early onset osteoarthritis of the hip joint.
Symptoms of Hip Impingement
Patients may not know that they have hip impingement. Hip impingement does not typically exhibit pain in the early stages and if it does feel painful, most patients associate it with a strained hip flexor. When confirmed that the cause of pain originates from hip impingement, a physician may call it Hip Impingement Syndrome. Symptoms of hip impingement include:
- Stiffness of the hip
- Inability or pain with hip flexion past 90 degrees
- Pain in the groin worsening with exercise or prolonged sitting
Causes of hip impingement
Hip Impingement falls into two categories: CAM and Pincer Impingement
In CAM Impingement, the femoral head has a slight or major defect. The shape of the head lacks the smooth shape necessary for proper hip function. The abnormal area of the head may get caught in the hip socket with flexion.
In Pincer Impingement, the anterior portion of the hip socket sticks out too far, creating a hook like structure. When a patient moves their hip into flexion, the femoral neck may hit the rim, causing pain and a decrease in mobility.
Some patients may have one type of hip impingement or may even have both.
Diagnosing Hip Impingement
If a hip doctor suspects hip impingent causing the patients pain, they perform a physical examination and order diagnostic testing. The diagnostic testing most likely consists of an X-Ray, followed with an MRI or CT scan if the X-Ray comes back conclusive. An MRI and CT allow the doctor to get a better look at the bony structures and abnormalities.
How to treat Hip Impingement
Doctors recommend starting with conservative treatment to treat hip impingement. Conservative treatment includes:
- Activity modifications
- Physical therapy
- Non-Sterioridal Anti-Inflammatory medications
If conservative treatments do not work, the treating physician may opt for surgical intervention.