Association of clinical and radiographic signs of femoroacetabular impingement in the general population

Abstract Background The relationships between the clinical and radiographic signs of femoroacetabular impingement (FAI) are unknown. The purpose of this study was to assess the relationship between hip pain, a positive anterior impingement sign (AIS), and radiographic signs of FAI in a general Japanese population. Methods A total of 616 individuals participated in this study. Hip pain was assessed using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) pain category score and the AIS was used as a provocation test. Participants were divided into a positive AIS group (at least one positive hip) and a negative AIS group. Radiographs were assessed for the cross-over sign (COS), ischial spine sign (ISS), posterior wall sign (PWS), and pistol grip deformity (PGD). Then, the relationships between the clinical and radiographic signs of FAI were evaluated. Results JHEQ pain scores did not differ between men and women. Seven men (3.4%) and 29 women (7.1%) had a least one hip with a positive AIS. The mean JHEQ pain scores were 22.9 ± 7.2 for the positive and 27.3 ± 2.2 for the negative AIS group (P  Conclusions Radiographic signs of FAI were not associated with the degree of hip pain or a positive AIS, which suggests that radiographic findings may not be important in the clinical diagnosis of FAI.