The hypertrophic portion of anterior inferior iliac spine was resected through the pseudarthrosis to leave a normal sized anterior inferior iliac spine which did not cause any impingement. Impingement occurred between the hypertrophic anterior inferior iliac spine and the anterior aspect of the femoral head/neck when the hip was flexed to nearly 90°. The hypertrophic anterior inferior iliac spine was noted with a pseudarthrosis at its base. The reflected and straight heads of rectus femoris were detached from their origins and to confirm the arthroscopic findings an arthrotomy was performed. Part of the tensor fascia lata and gluteus medius was detached from the iliac crest to enhance the display of the joint capsule. Through the interval between the rectus femoris and the gluteus medius, the joint capsule was identified. The hip was explored using a Smith-Petersen approach. 2).Īrthroscopy of the right hip showed normal cartilage on the femoral head and acetabulum and no labral damage. The axial CT scan and a three-dimensional reconstruction revealed hypertrophy of the anterior inferior iliac spine with a pseudarthrosis through its base. In addition there was an abnormality at the femoral head-neck junction and an altered offset to the right hip. The pelvic anteroposterior (AP) radiograph showed an abnormal appearance just above the anterior superior rim of the right acetabulum which extended inferiorly ( Fig. With the hip flexed to 90° with adduction internal rotation provoked severe groin pain. There was tenderness in the right groin with only 90° of hip flexion and marked restriction of internal rotation. There was no previous medical history and no history of trauma to the hip or symptoms from the lumbar spine or contralateral hip. He had been treated with nonsteroidal anti-inflammatory drugs and physiotherapy, but without benefit. The pain was usually induced by jumping and running but could develop after prolonged walking. Case reportĪ 30-year-old man who had been an enthusiastic football player and athlete since school age presented with a ten-year history of right groin pain. We report the clinical presentation, radiological and CT findings and operative treatment of a patient who was referred with groin pain.
6 – 8 However, impingement between the femoral head-neck junction and an abnormally hypertrophic anterior inferior iliac spine has, to our knowledge, not been reported. 3 – 5 Repeated impingement between the anterior femoral head-neck junction and anterior aspect of the acetabulum has been shown to lead to not only chronic groin pain but also dysfunction of the hip joint, especially in young active patients in whom arthroscopic treatment might be appropriate. 1 – 2 It has been attributed to structural abnormalities involving both the acetabulum and femoral head-neck junction. Femoro-acetabular impingement is currently considered to be one of the causes for progressive degenerative damage to the articular cartilage of the hip producing osteoarthritis.
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