Abnormal Extension of the Femoral Head Epiphysis as a Cause of Cam Impingement

  • Siebenrock K
  • Wahab K
  • Werlen S
 et al. 
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Abstract

The etiology of an insufficient femoral head-neck offset has not been identified yet. It was investigated whether a decreased head-neck offset might be correlated with an unusual orientation of the physeal capital scar. Therefore, the femoral head-neck offset and the extension of the physeal scar onto the femoral neck were mea-sured with specific magnetic resonance imaging arthrography. The measurements were done in 15 patients with anterior femoroacetabu-lar impingement attributable to a nonspherical head and were com-pared with 15 age-and gender-matched control subjects. Eight serial magnetic resonance imaging sections perpendicular to the femoral neck axis were used in each hip to measure the head-neck offset and the epiphyseal extension toward the femoral neck at 16 measurement points. In both groups there was an inverse correlation between the amount of head-neck offset and the relative extension of the capital physeal scar in the cranial hemisphere of the head. Within the antero-superior head quadrant, there was statistically significant different de-crease of the head-neck offset and increase of the lateral epiphyseal extension in the patients compared with the control subjects. These findings suggest a growth abnormality of the capital physis as one probable underlying cause for a nonspherical head.

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