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The False-Profile View May Be Used to Identify Cam Morphology
Michael D Hellman1, Randy Mascarenhas2, Anil Gupta2
1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
Summary
The false-profile hip X-ray view accurately identifies cam deformities, especially anterior ones. This view, along with others, is a reliable screening tool for femoroacetabular impingement.
Area of Science:
- Orthopaedic Surgery
- Radiology
- Medical Imaging Analysis
Background:
- Femoroacetabular impingement (FAI) is a condition characterized by abnormal hip morphology.
- Cam deformity, a type of FAI, involves an abnormal shape of the femoral head-neck junction.
- Accurate diagnosis of cam deformity is crucial for effective management and surgical planning.
Purpose of the Study:
- To evaluate the accuracy of measuring the alpha angle on different hip radiographic views (false-profile, anteroposterior, 90° Dunn lateral) compared to computed tomography (CT).
- To determine the sensitivity and specificity of these radiographic views in diagnosing cam deformities.
- To assess the reproducibility of alpha angle measurements on the false-profile view.
Main Methods:
- Retrospective review of 45 patients undergoing hip arthroscopy with preoperative radiographs and CT scans.
- Alpha angles were measured on AP, 90° Dunn lateral, and false-profile radiographs, and CT reformatted views.
- Measurements were compared between imaging modalities, with abnormal alpha angles defined as >50.5°.
Main Results:
- The false-profile view demonstrated 60% sensitivity and 89.0% specificity for cam deformities.
- Combined radiographs showed 86% sensitivity and 75% specificity.
- The false-profile view showed strong correlation with the 2-o'clock (R=0.746) and 3-o'clock (R=0.698) positions.
- Intraclass correlation coefficient for the false-profile view was 0.81, indicating good reproducibility.
Conclusions:
- The false-profile view is effective in characterizing hip cam deformity, particularly anterior deformities at the 3-o'clock position.
- Measuring the alpha angle on the false-profile view is reproducible.
- A radiographic series including the false-profile, standing AP pelvis, and 90° Dunn lateral views is a suitable screening tool for femoroacetabular impingement.
