[image: XR_1.jpeg]
I’m not sure if I’m just seeing things….or paying too much attention to
XRs…but I am confused by this. I THINK I’m seeing bilateral crossover
signs…indicative of superior acetabular retroversion….but …
[image: 35F 2 mos rt hip popping 2.jpeg]
There seems to be a bit of an extra bump, more prominent on the right—and
I wonder if the AIIS is a bit long….don’t know how to judge that (I’m
sure someone does).
[image: 35F 2 mos rt hip popping 3.jpeg]
We only do the lateral view on the symptomatic side, so I don’t know if the
CAM morphology is just on the right, or bilateral…..but I think that AIIS
is looking big here too.
Can you have Triple Mixed FAI including CAM, Pincer and Subspine
impingement?
I think I’ve called subspine impingement on MRI maybe 1-2 times with an
old-post traumatic exostosis….I don’t even know the criteria for
developmental prominence.
Is it better to assess with MRI or CT?
This patient was referred by a family practitioner….I suppose it’s
enough to get her to an orthopedist. Just wondering what you think.
Hilary
1 thought on “35F 2 months Rt hip pain and popping, XR, Please Help”
hilary.umans
I received the most helpful response from Mohammad Sammim, from NYU:
I agree this is AIIS. I have included three slides of the recent talk from
ISS and an article. The last slide shows the different AIIS types based on
the extent of the subspine in relation to the ant rim.
[image: image.png]
[image: image.png]
[image: image.png]
Article: Krueger DR, Windler M, Geßlein M, Schuetz M, Perka C, Schroeder
JH. Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP
pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions.
Arch Orthop Trauma Surg. 2017 Jul;137(7):975-980. doi:
10.1007/s00402-017-2694-y. Epub 2017 Apr 21. PMID: 28432458.
I missed the lecture, because I was attending the concurrent session!
But the videos on demand are fabulous.
For those of you with access to the ISS meeting app, I recommend watching
Mohammad’s lecture, it’s excellent and explains everything you ever wanted
to know about subspine impingement….along with other forms of
extra-articular hip impingement.
I agree this is AIIS. I have included three slides of the recent talk from
ISS and an article. The last slide shows the different AIIS types based on
the extent of the subspine in relation to the ant rim.
[image: image.png]
[image: image.png]
[image: image.png]
Article: Krueger DR, Windler M, Geßlein M, Schuetz M, Perka C, Schroeder
JH. Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP
pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions.
Arch Orthop Trauma Surg. 2017 Jul;137(7):975-980. doi:
10.1007/s00402-017-2694-y. Epub 2017 Apr 21. PMID: 28432458.
I missed the lecture, because I was attending the concurrent session!
But the videos on demand are fabulous.
For those of you with access to the ISS meeting app, I recommend watching
Mohammad’s lecture, it’s excellent and explains everything you ever wanted
to know about subspine impingement….along with other forms of
extra-articular hip impingement.
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