Hello dear ocaders!
This is a patient that I know. She is a good physiotherapist and has lots
of problems with her hips. She wrote: “I always have pain which radiates to
the groin. I also feel pain in flexion and external rotation, as well as
hip abduction”.
First question: I don’t see Cam type deformity. But her femoral heads are
not quite spherical as I am used to see. Does anyone agree with me? I
pointed out my concern with some arrows in image, but I actually
don’t think that this would cause impingement. She has MRI which
demonstrates labral tears that can explain her pain, but still, I don´t
like her bone morphology.
Second question: Forget about my case. After I watched Henry Bone Ellis
lecture here in OCAD, I am wondering about soft Cam. Does anyone “believe”
in that? Has seen a case? Does have literature to share?
Third question: I couldn´t ask Dr. Henry about lateral cam. My hip
orthopedist told me that about 5% of patients with cam have an anterior
“bump” that extends laterally (a “lateral” cam). Is there any measure for
that? I just find omega angle in literature, which I find very complicated
to reproduce in daily practice.
Thanks to all. Have a great day!
Karina Todeschini
(this is from Dr. Ellis)
Thank you for your comments on FAI and my talk last month. Your questions are fantastic! I hope I can adequately answer then but please reach out with additional questions
Completely agree with your thoughts on these radiographs. Although we often time talk about a traditional CAM that cause impingement/labral tears, but often times there are more factors that include acetabular morphology. Sometimes a aspherical femoral head (although not classic cam) can cause labral tears and impingement. I would not call this a cam lesion though.
Soft CAM: I have presented this case series at the International Society of Hip Preservation and have not seen it described elsewhere. Although we are submitting the manuscript within the week, I still have a lot to learn to figure out if this is real.
For the far lateral cam, I typically measure the alpha angle on the AP pelvis.
Henry Bone Ellis, Jr., M.D.
Texas Scottish Rite Hospital For Children
Associate Professor, University of Texas Southwestern
Pediatric Orthopaedic / Sports Medicine
http://www.scottishritehospital.org/sports
Henry.Ellis@tsrh.org
Hello ocaders!
I had some nice replies to my e-mail. Hilary has sent to Dr Ellis himself
(thanks, Hilary!!), which brought some value information, pasted bellow.
After I realize that this patient has fovea alta, maybe a mild dysplasia;
Roar Petersen agreed with me. Others think she has acetabular retroversion,
which I am personally not sure.
Thanks to everyone, this group is great!
Thank you for your comments on FAI and my talk last month. Your questions
are fantastic! I hope I can adequately answer then but please reach out
with additional questions
1. Completely agree with your thoughts on these radiographs. Although
we often time talk about a traditional CAM that cause impingement/labral
tears, but often times there are more factors that include acetabular
morphology. Sometimes a aspherical femoral head (although not classic cam)
can cause labral tears and impingement. I would not call this a cam lesion
though.
2. Soft CAM: I have presented this case series at the International
Society of Hip Preservation and have not seen it described elsewhere.
Although we are submitting the manuscript within the week, I still have a
lot to learn to figure out if this is real.
3. For the far lateral cam, I typically measure the alpha angle on the
AP pelvis.
Em ter., 9 de mar. de 2021 às 10:27, Karina <todeschinikarina@gmail.com>
escreveu: