Clinical presentation of femoroacetabular impingement.

Knee Surg Sports Traumatol Arthrosc. 2007 Aug;15(8):1041-7. Epub 2007 May 12.

Philippon MJ, Maxwell RB, Johnston TL, Schenker M, Briggs KK.

Steadman Hawkins Research Foundation, Attn: Clinical Research, 181 W. Meadow Dr. Ste 1000, Vail, CO 81657, USA.

The purpose of this study was to identify subjective complaints and objective findings in patients treated for femoroacetabular impingement (FAI). Three hundred and one arthroscopic hip surgeries were performed to treat FAI. The most frequent presenting complaint was pain, with 85% of patients reporting moderate or marked pain. The most common location of pain was the groin (81%). The average modified Harris Hip score was 58.5 (range 14-100). The average sports hip outcome score was 44.0 (range 0-100). The anterior impingement test was positive in 99% of the patients. Range of motion was reduced in the injured hip. Patients who had degenerative changes in the hip had a greater reduction in range of motion. The most common symptom reported in patients with FAI was groin pain. Patient showed decreased ability to perform activities of daily living and sports. Significant decreases in hip motion were observed in operative hips compared to non-operative hips.

Hip joint pain referral patterns: a descriptive study.

Pain Med. 2008 Jan;9(1):22-5.

Lesher JM, Dreyfuss P, Hager N, Kaplan M, Furman M.

Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.

Objective. To determine hip joint pain referral patterns. Design. Retrospective analysis. Setting. Multicenter. Patients. Fifty-one consecutive patients meeting clinical criteria of a symptomatic hip joint. Interventions. Fluoroscopically guided intra-articular hip joint injection. Outcome Measures. Anatomic pain map before hip injection and visual analog scale both before and after hip injection. Results. The hip joint was shown to cause pain in traditionally accepted referral areas to the groin and thigh in 55% and 57% of patients, respectfully. However, pain referral was also seen in the buttock and lower extremity distal to the knee in 71% and 22%, respectively. Foot and knee pain were seen in only 6% and 2% of patients, respectively, while lower lumbar spine referral did not occur. Fourteen pain referral patterns were observed. Conclusions. Buttock pain is the most common pain referral area from a symptomatic hip joint. Traditionally accepted groin and thigh referral areas were less common. Hip joint pain can occasionally refer distally to the foot. Lower lumbar spine referral did not occur.