Research of femoroacetabular impingement syndrome by means of evaluating the imagined routine ap-pelvis radiographies in PACS

In this study, to assess recently achieved diagnosis criteria of FAI which causes premature osteoartritis in hip joint, what the accurate radiological imagining techniques and assessment criteria are, comparison of radiological findings that belong to FAI through imagining and indirect MR arthrography, clinical examining of patients with radiological FAI findings comparison of clinical and radiological findings have been aimed. Also, useful radiological findings for the diagnosis and assessment of pre-surgical treatment of FAI have been described.In our study, without any sexual discrimination, in PACS 446 patients? AP pelvis graphics were taken into consideration in aspect of FAI. Of all examined AP-Pelvis graphics, 34 in 446 patients either radiographic findings of FAI were run into or suspected.In order to investigate the presence of cam impingement in these 34 patients,oblique axial graphy of the hip was imagined at the painful side, 23 in 446 patients indirect hip MR arthrography was applied. Also, all of the patients were examined by physical treatment authority through impingement tests, VAS scores were accomplished and their joint movement extents were assessed. Through radiographies and indirect MR arthrography, diagnosis criteria in the types of FAI and variation of FAI in hip bone and soft tissue were noted As statistical method, Shapio Wilks test, chi-square test, student-t test, Varians Analysis, among Post Hoc tests Tukey test, Mann-Whitne U test and Kruskal Wallis H test were used.21 in 446 patients pincer type, in 5 patients cam type and in 8 patients mixed type FAI were diagnosed.Also,of all cam type FAI patients, in 2 patients both in lateral and in anterior facal prominence were proved in femoral head-neck junction ( mixed type cam ). Between FAI types, according to the distribution of the patients through gender there was no statistically meaningful difference. However, it was observed that pincer type was more common in women whereas cam type was more common in men.There were 16 patients under the age of 45 and 18 patients over the age of 46. There was no meaningful difference between the age groups. It was also observed that apart from other findings, herniasion pit has meaningfully differentiated between FAI types.In the measurements through indirect MR arthrography alfa angel, head-neck offset and head-neck offset ratio have showed statistically meaningful difference in cam type FAI rather than the other FAI groups. We have compared and contrasted alfa angel, head-neck offset and offset ratio parametres with MR arthrography taken in cross-table graphy and oblique axial plan. Among the measurements held through both imagining modalities statistically meaningful difference has not been proved.6 in 23 patients with indirect MR arthrography, acetabular cartilage damage, in 8 patients labral damage were observed. Acetabular roof lesion has been proved in 6 patients.In cam type FAI the average of E value has statistically meaningful difference than the other FAI types. Apart from these, there has been no meaningful differences in the other parametres.The longest pain period has been proved in pincer type and the biggest VAS score in cam type FAI.According to the FAI types there were no meaningful differences in pain localizations. However, in all of the FAI types, the pain in femur and its surroundings was observed much more often than in groin and its surroundings. When pain localizations were concerned according to the distribution of FAI types, the most common localization was observed in femur posterior side and in pincer type. In the distribution of examination tests according to FAI types statistically no difference was observed.In pincer type of FAI, `C? sign, impingement, drehman, posterior impingement, fabere and fadere tests were much more often positive than cam type FAI. In FAI types there were no statistically meaningful differences in terms of measured motion clearness. In the distribution of avarage value of patients? Nonarthritic Hip Score numbers according to FAI types statistically no meaningful difference was proved.The imagining techniques of AP-Pelvis and `cross-table? graphies were observed to be the most important in order to be able to interpret the case accurately .While evaluating the radiographies in PACS in aspect of FAI, drawing a circle that suits femur head is a helpful technical detail. It was observed that herniasion pit is an important marker in FAI and seconder ossicule is more common in pincer type FAI patients and in patients over 46. Labral damage in indirect MR arthrography could only be assessed in T1-weight series as diffuse signal increase. Therefore, it was obseved that indirect MR is not sufficient in describing labral pathologies. It was also observed that among the sequences used in indirect MR arthrography 3D WATS was sufficient enough in imagining cartilage pathologies and the signals taken from cartilaginous were very well. It has been concluded that positions of labro cartilaginous damage identified in indirect MR arthrography was matched with the literature. The most common localization of the pain was cartilage posterior, and the most common FAI type was pincer. This was thought to be as in not treated pincer type progressed osteoartritis process. In this study,average pain period was found to be 59 months which leads us to think that this disease cannot be diagnosed sufficiently by authorities and radiologists in the early stages of FAI. It was also concluded that patients with FAI in the clearness of hip joint movements especially loss of internal rotation must bring FAI in mind. Average NHAS score was 54,22.Anamnez, careful physical examination and especially hip impingement tests were very important for diagnosis in these patients and we observed that through AP-Pelvis and cross-table graphy it?s possible to diagnose pincer and cam type FAI.