Correlation between the prevalence of herniation pits and the alpha angle of the hip: computed tomography evaluation in healthy Chinese adults

BMC Musculoskeletal Disorders

Xiao-guang Cheng¹  Yong-bin Su¹  Li Xu¹  Zhe Guo¹ 

[1] Department of Radiology, Beijing Jishuitan Hospital, 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China

关键词: Computed tomography;    Alpha angle;    Femoral neck;    Prevalence;    Herniation pits;   

Others  :  1129528
DOI  :  10.1186/1471-2474-14-288

 received in 2013-01-24, accepted in 2013-10-01,  发布年份 2013

【 摘 要 】

Background

Herniation pits (HPs) commonly develop over time at the femoral head–neck junction in adults, but their cause is still under debate. The purpose of study reported here was to investigate the correlation between the prevalence of HPs of the femoral neck and the alpha angle of the hips of healthy Chinese adults, by using computed tomography (CT).

Methods

Six hundred and seventy Chinese adults (representing 1145 hips) who had no known diseases affecting the proximal femur and had no symptoms of femoroacetabular impingement underwent a 64-slice CT scan for medical purposes that included the hip in the scan range. Their CT data were analyzed for the prevalence of HPs in the femoral necks and for hip alpha angles.

Results

The overall prevalence of femoral-neck HPs was 12.5% (143 of 1145 hips). The prevalence in the left versus right femoral necks was 12.1% (69 of 569 hips) versus 12.8% (74 of 576 hips). There was no statistically significant difference between the two sides (χ² = 0.136; p = 0.712). The prevalence of HPs was greater in men than in women (15.9% vs 7.7%; p < 0.01) and greater in adults older than 30 years than in adults younger than 30 years (χ²= 14.547; p < 0.01). The alpha angles were greater in the 143 proximal femora with HPs than in the 1002 without pits (39.95° ± 6.01° vs 37.97° ± 5.14°; p < 0.01).

Conclusions

The prevalence of HPs of the femoral neck in healthy adults was 12.5%, and the prevalence was greater in men than in women. There is a correlation between the prevalence of HPs and the contour of the femoral head–neck junction. The formation of pits may be attributed to the combination of degeneration and morphologic variances in the femoral head–neck junction.

【 授权许可】

   
2013 Guo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Pitt MJ, Graham AR, Shipman JH, et al.: Herniation pits of the femoral neck. AJR Am J Roentgenol 1982, 138(6):1115-1121.
• [2]Luan H, Huang ZG: CT features and total prevalence of herniation pits of the femoral neck in adults [In Chinese.]. J Clin Radiol 2008, 27:1538-1540.
• [3]Gao ZH, Liu JH, Meng QF, et al.: The study of imageology on herniation pit of the femoral neck [In Chinese.]. Zhonghua Fang She Xue Za Zhi 2005, 39:531-534.
• [4]Panzer S, Piombino-Mascali D, Zink AR: Herniation pits in human mummies: a CT investigation in the Capuchin Catacombs of Palermo, Sicily. PLoS One 2012, 7(5):e36537.
• [5]Daenen B, Preidler KW, Padmanabhan SP, et al.: Symptomatic herniation pits of the femoral neck: anatomic and clinical study. AJR Am J Roentgenol 1997, 168(1):149-153.
• [6]Leunig M, Beck M, Kalhor M, et al.: Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 2005, 236:237-246.
• [7]Kim JA, Park JS, Jin W, et al.: Herniation pits in the femoral neck: a radiographic indicator of femoroacetabular impingement. Skeletal Radiol 2011, 40:167-172.
• [8]Panzer S, Augat P, Scheidler J: Herniation pits and their renaissance in association with femoroacetabular impingement. Rofo 2010, 182:565-572. In German
• [9]James SL, Connel DA, O’Donnell P, et al.: Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction. Clin Radiol 2007, 62:472-478.
• [10]Notzli HP, Wyss TF, Stoecklin CH, et al.: The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 2002, 84:556-560.
• [11]Beall DP, Sweet CF, Martin HD, et al.: Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 2005, 34:691-701.
• [12]Kassarjian A, Yoon LS, Belzile E, et al.: Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology 2005, 236:588-592.
• [13]Panzer S, Augat P, Esch U: CT assessment of herniation pits: prevalence, characteristics, and potential association with morphological predictors of femoroacetabular impingement. Eur Radiol 2008, 18:1869-1875.
• [14]Daenen B, Preidler KW, Padmanabhan S, et al.: Symptomatic herniation pits of the femoral neck. AJR Am J Roentgenol 1997, 168:149-153.
• [15]Gao ZH, Yin JQ, Ma L, et al.: Clinical imaging characteristics of herniation pits of the femoral neck. Orthop Surg 2009, 1:189-195.
• [16]Wook J, Ji Seon P, Jin Ah K: Herniation pits in the femoral neck: a radiographic indicator of femoroacetabular impingement. Skeletal Radiol 2011, 40(2):167-172.
• [17]Hoaglund FT, Oishi CS, Gialamas GG: Extreme variations in racial rates of total hip arthroplasty for primary coxarthrosis: a population-based study in San Francisco. Ann Rheum Dis 1995, 54:107-110.
• [18]Sánchez Bayle M, Aranguren Jiménez A, Cabello Gómez P, et al.: A longitudinalstudy of physicalexercisepractice in children. The influence of age, gender and socioeconomiclevel. The WorkingGroup on CardiovascularRiskFactors in Childhood and Adolescence. An Esp Pediatr 1998, 48:25-27. In Spanish
• [19]National Center for Health Statistics: Health, United States, 2012: With Special Featureon Emergency Care. Hyattsville, MD; 2013. Available at http: //www.cdc.gov/nchs/data/hus/hus12.pdf webcite
• [20]Tannast M, Siebenrock KA, Anderson SE: Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol 2007, 188:1540-1552.