Advances in FAI Imaging: a Focused Review
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OUTCOMES RESEARCH IN ORTHOPEDICS (O AYENI, SECTION EDITOR)
Advances in FAI Imaging: a Focused Review Vasco V. Mascarenhas 1 & António Caetano 2 & Pedro Dantas 3 & Paulo Rego 4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Femoroacetabular impingement (FAI) is one of the main causes of hip pain in young adults and poses clinical challenges which have placed it at the forefront of imaging and orthopedics. Diagnostic hip imaging has dramatically changed in the past years, with the arrival of new imaging techniques and the development of magnetic resonance imaging (MRI). This article reviews the current state-of-the-art clinical routine of individuals with suspected FAI, limitations, and future directions that show promise in the field of musculoskeletal research and are likely to reshape hip imaging in the coming years. Recent Findings The largely unknown natural disease course, especially in hips with FAI syndrome and those with asymptomatic abnormal morphologies, continues to be a problem as far as diagnosis, treatment, and prognosis are concerned. There has been a paradigm shift in recent years from bone and soft tissue morphological analysis towards the tentative development of quantitative approaches, biochemical cartilage evaluation, dynamic assessment techniques and, finally, integration of artificial intelligence (AI)/deep learning systems. Summary Imaging, AI, and hip preserving care will continue to evolve with new problems and greater challenges. The increasing number of analytic parameters describing the hip joint, as well as new sophisticated MRI and imaging analysis, have carried practitioners beyond simplistic classifications. Reliable evidence-based guidelines, beyond differentiation into pure instability or impingement, are paramount to refine the diagnostic algorithm and define treatment indications and prognosis. Nevertheless, the boundaries of morphological, functional, and AI-aided hip assessment are gradually being pushed to new frontiers as the role of musculoskeletal imaging is rapidly evolving. Keywords Femoroacetabular impingement . Hip . Magnetic resonance imaging . Computed tomography . Advanced imaging . Artificial intelligence
Introduction Femoroacetabular impingement (FAI) is a motion-driven hip disorder presenting as a specific triad of clinical and imaging findings and is the most common cause of early-onset
osteoarthritis (OA) in a non-dysplastic hip [1••, 2•, 3•]. Three distinct types are classically recognized in the literature—the cam, pincer, and mixed types—based on a predominance of either femoral, acetabular, or combined abnormalities. Starting from this over simplistic approach, hip
This article is part of the Topical Collection on Outcomes Research in Orthopedics * Vasco V. Mascarenhas [email protected]
1
Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Avenida Lusíada 100, 1500-650 Lisbon, Portugal
António Caetano [email protected]
2
Radiology Department, C
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