Abstract
The normal value of alpha angle is controversial. The aim of this study was to compare the alpha angle in asymptomatic volunteers versus patients who had undergone surgery for symptomatic cam-type femoroacetabular impingement (FAI) and determine a diagnostic cut-off value for symptomatic cam impingement. This is a diagnostic test study. Cases were defined as those patients who had undergone surgery for symptomatic cam or mixed type FAI. Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason. In both groups, the alpha angle was measured in an oblique axial CT reconstruction of the femoral neck. A logistic regression model was first estimated and a receiver operating characteristics (ROC) curve was then calculated. The diagnostic cut-off value selected was the one that maximizes sensitivity and specificity. Data were analysed from 38 consecutive cases of cam or mixed FAI and 101 controls. The average alpha angle was 67°(±12°) among cases and 48°°(±5°) among controls. An odds ratio of 1.28 [1.18–1.39] was obtained. A ROC curve of 0.96 [0.93–0.99] was calculated, and using an alpha angle of 57° as the diagnostic cut-off value, provided a sensitivity of 92% and a specificity of 95%. If a patient complains of hip pain and an alpha angle of 57° is found in CT, strongly suggest that cam impingement is causing the pain.
Highlights
Controls were defined as asymptomatic volunteers, with no history of hip pain who had undergone a computed tomography (CT) scan of the abdomen and pelvis for a non-joint or bone-related reason
The alpha angle was measured in an oblique axial CT reconstruction of the femoral neck
If a patient complains of hip pain and an alpha angle of 57 is found in CT, strongly suggest that cam impingement is causing the pain
Summary
Femoroacetabular impingement (FAI) is an anatomic and functional condition that results in a mechanical conflict in the hips, producing pathological contact between the acetabulum and the femoral head–neck junction. This can lead to labral–chondral injury, pain and limited range of motion. Three types of FAI have been described: pincer, cam and mixed. Pincer FAI is characterized by focal or general overcoverage of the femoral head by the acetabulum, while cam-type FAI is characterized by the presence of an aspherical portion of the femoral head–neck junction. The mixed type is diagnosed when both types of impingements are found [3, 4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
