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Hip shape is symmetric, non-dependent on limb dominance and gender-specific : implications for femoroacetabular impingement : a 3D CT analysis in asymptomatic subjects

(2018) EUROPEAN RADIOLOGY. 28(4). p.1609-1624
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Abstract
To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. We prospectively included 590 patients and evaluated 1111 hips with semi-automated CT analysis. We calculated overall, side- and sex-specific parameters for imaging signs of cam [omega and alpha angle (alpha A degrees)] and pincer-type morphology [acetabular version (ACvers), lateral centre-edge angle (LCEA) and cranio-caudal coverage]. Hip shape was symmetrical and did not depend on limb dominance. The 95% RefInt limits were sex-different for all cam-type parameters and extended beyond current abnormal thresholds. Specifically, the upper limits of RefInt for alpha A degrees at 12:00, 1:30 and 3:00 o'clock positions were 56A degrees, 70A degrees and 58A degrees, respectively, and 45A degrees for LCEA. Acetabular morphology varied between age groups, with a trend toward an LCEA/ACvers increase over time. Our morphometric measurements can be used to estimate normal hip morphology in asymptomatic individuals. Notably they extended beyond current thresholds used for FAI imaging diagnosis, which was most pronounced for cam-type parameters. We suggest the need to reassess alpha A degrees RefInt and consider a 60A degrees threshold for the 12:00/3:00 positions and 65-70A degrees for other antero-superior positions. - Hip shape is symmetrical regardless of limb dominance. - Pincer/cam morphology is frequent in asymptomatic subjects (20 and 71%, respectively). - LCEA and acetabular version increases with age (5-7A degrees between opposite age groups). - Femoral morphology is stable after physeal closure (in the absence of pathology). - Alpha and omega angle thresholds should be set according to sex.
Keywords
Hip, Femoroacetabular impingement, Multidetector computed tomography, Reference value, Normal value, CENTER-EDGE ANGLE, CAM-TYPE DEFORMITIES, MALE SOCCER PLAYERS, ALPHA ANGLE, COMPUTED-TOMOGRAPHY, FEMORAL-HEAD, GROIN PAIN, ACETABULAR RETROVERSION, MORPHOLOGY IMPLICATIONS, RADIOGRAPHIC FINDINGS

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Citation

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Chicago
Mascarenhas, Vasco V, Paulo Rego, Pedro Dantas, Miguel Castro, Lennart Jans, Rui M Marques, Nélia Gouveia, Francisco Soldado, Olufemi R Ayeni, and José G Consciência. 2018. “Hip Shape Is Symmetric, Non-dependent on Limb Dominance and Gender-specific : Implications for Femoroacetabular Impingement : a 3D CT Analysis in Asymptomatic Subjects.” European Radiology 28 (4): 1609–1624.
APA
Mascarenhas, V. V., Rego, P., Dantas, P., Castro, M., Jans, L., Marques, R. M., Gouveia, N., et al. (2018). Hip shape is symmetric, non-dependent on limb dominance and gender-specific : implications for femoroacetabular impingement : a 3D CT analysis in asymptomatic subjects. EUROPEAN RADIOLOGY, 28(4), 1609–1624.
Vancouver
1.
Mascarenhas VV, Rego P, Dantas P, Castro M, Jans L, Marques RM, et al. Hip shape is symmetric, non-dependent on limb dominance and gender-specific : implications for femoroacetabular impingement : a 3D CT analysis in asymptomatic subjects. EUROPEAN RADIOLOGY. 2018;28(4):1609–24.
MLA
Mascarenhas, Vasco V et al. “Hip Shape Is Symmetric, Non-dependent on Limb Dominance and Gender-specific : Implications for Femoroacetabular Impingement : a 3D CT Analysis in Asymptomatic Subjects.” EUROPEAN RADIOLOGY 28.4 (2018): 1609–1624. Print.
@article{8614796,
  abstract     = {To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. 
We prospectively included 590 patients and evaluated 1111 hips with semi-automated CT analysis. We calculated overall, side- and sex-specific parameters for imaging signs of cam [omega and alpha angle (alpha A degrees)] and pincer-type morphology [acetabular version (ACvers), lateral centre-edge angle (LCEA) and cranio-caudal coverage]. 
Hip shape was symmetrical and did not depend on limb dominance. The 95% RefInt limits were sex-different for all cam-type parameters and extended beyond current abnormal thresholds. Specifically, the upper limits of RefInt for alpha A degrees at 12:00, 1:30 and 3:00 o'clock positions were 56A degrees, 70A degrees and 58A degrees, respectively, and 45A degrees for LCEA. Acetabular morphology varied between age groups, with a trend toward an LCEA/ACvers increase over time. 
Our morphometric measurements can be used to estimate normal hip morphology in asymptomatic individuals. Notably they extended beyond current thresholds used for FAI imaging diagnosis, which was most pronounced for cam-type parameters. We suggest the need to reassess alpha A degrees RefInt and consider a 60A degrees threshold for the 12:00/3:00 positions and 65-70A degrees for other antero-superior positions. 
- Hip shape is symmetrical regardless of limb dominance. 
- Pincer/cam morphology is frequent in asymptomatic subjects (20 and 71%, respectively). 
- LCEA and acetabular version increases with age (5-7A degrees between opposite age groups). 
- Femoral morphology is stable after physeal closure (in the absence of pathology). 
- Alpha and omega angle thresholds should be set according to sex.},
  author       = {Mascarenhas, Vasco V and Rego, Paulo and Dantas, Pedro and Castro, Miguel and Jans, Lennart and Marques, Rui M and Gouveia, Nélia and Soldado, Francisco and Ayeni, Olufemi R and Consciência, José G},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keywords     = {Hip,Femoroacetabular impingement,Multidetector computed tomography,Reference value,Normal value,CENTER-EDGE ANGLE,CAM-TYPE DEFORMITIES,MALE SOCCER PLAYERS,ALPHA ANGLE,COMPUTED-TOMOGRAPHY,FEMORAL-HEAD,GROIN PAIN,ACETABULAR RETROVERSION,MORPHOLOGY IMPLICATIONS,RADIOGRAPHIC FINDINGS},
  language     = {eng},
  number       = {4},
  pages        = {1609--1624},
  title        = {Hip shape is symmetric, non-dependent on limb dominance and gender-specific : implications for femoroacetabular impingement : a 3D CT analysis in asymptomatic subjects},
  url          = {http://dx.doi.org/10.1007/s00330-017-5072-9},
  volume       = {28},
  year         = {2018},
}

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