InfographicThis infographic illustrates the natural history of primary cam morphology (PCM) to inform the Oxford Consensus Study's seven prioritised research domains on conditions affecting the young person's hip. 1 2 We share 16 key messages for athletes, patients, clinicians and researchers:1.Among other possible risk factors (including genetics), playing a highload sport like football (soccer) or ice hockey while growing (during adolescence) is the key risk factor for developing PCM. 3 4 2.Many young athletes have asymptomatic PCM.However, at present, no one knows how many; clinicians and researchers have 'measured' PCM in different ways (often using alpha angles on imaging). 53. PCM seems more common in males.Research on PCM in females is sparse; no studies have yet investigated how PCM develops in female athletes. 54. Clinicians and researchers cannot predict who will develop PCM.Therefore, coaches cannot, with confidence, manipulate training to reduce a young athlete's risk of developing PCM. 5. Most athletes who have PCM thrive; they compete with 'happy hips' and never develop symptoms.6.Some athletes with PCM develop symptoms like hip-related pain.This is called 'femoroacetabular impingement (FAI) syndrome.' 6A few athletes with FAI syndrome might develop hip osteoarthritis (OA) in the future. 77. Clinicians and researchers cannot yet predict the 'at risk' athletes with PCM who might develop hip disease such as FAI syndrome or hip OA.However, size matters; large alpha angles are associated with a greater risk of developing hip OA. 8 8.The word 'syndrome' has a negative connotation to many patients.Most athletes with FAI syndrome do well when treated with a combination of education and progressive exercise rehabilitation.on July 16,
Twelve families that were multiply affected with diffuse idiopathic skeletal hyperostosis (DISH) and/or chondrocalcinosis, were identified on the island of Terceira, The Azores, potentially supporting the hypothesis that the 2 disorders share common etiopathogenic factors. The present study was undertaken to investigate this hypothesis.One hundred three individuals from 12 unrelated families were assessed. Probands were identified from patients attending the Rheumatic Diseases Clinic, Hospital de Santo Espírito, in The Azores. Family members were assessed by rheumatologists and radiologists. Radiographs of all family members were obtained, including radiographs of the dorsolumbar spine, pelvis, knees, elbows, and wrists, and all cases were screened for known features of chondrocalcinosis.Ectopic calcifications were identified in 70 patients. The most frequent symptoms or findings were as follows: axial pain, elbow, knee and metacarpophalangeal (MCP) joint pain, swelling, and/or deformity, and radiographic enthesopathic changes. Elbow and MCP joint periarticular calcifications were observed in 35 and 5 patients, respectively, and chondrocalcinosis was identified in 12 patients. Fifteen patients had sacroiliac disease (ankylosis or sclerosis) on computed tomography scans. Fifty-two patients could be classified as having definite (17%), probable (26%), or possible (31%) DISH. Concomitant DISH and chondrocalcinosis was diagnosed in 12 patients. Pyrophosphate crystals were identified from knee effusions in 13 patients. The pattern of disease transmission was compatible with an autosomal-dominant monogenic disease. The mean age at which symptoms developed was 38 years.These families may represent a familial type of pyrophosphate arthropathy with a phenotype that includes peripheral and axial enthesopathic calcifications. The concurrence of DISH and chondrocalcinosis suggests a shared pathogenic mechanism in the 2 conditions.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
