Correlation Between Cam-Type Femoroacetabular Impingement and Radiographic Osteitis Pubis

A mechanistic link has been suggested between cam-type femoroacetabular impingement and increased stress on the symphysis pubis. This retrospective study was conducted to determine whether there is an increased prevalence of osteitis pubis, as evidenced by imaging, in patients with femoroacetabular impingement compared with age-matched control subjects. Search of a radiologic database of a large academic health institution for all patients with cam-type femoroacetabular impingement diagnosed by magnetic resonance imaging or magnetic resonance arthrogram between January 2000 and October 2013 identified 46 cases. Two radiologists reviewed these cases independently and confirmed the presence of femoroacetabular impingement based on alpha angle and other characteristics of cam morphology. The imaging studies were further evaluated for characteristics of osteitis pubis, with severity graded from minimal to severe on a 4-point Likert scale. A control group composed of age-matched subjects without diagnosed femoroacetabular impingement was also evaluated for osteitis pubis. A statistically significant increase in the prevalence of osteitis pubis was found in patients with femoroacetabular impingement compared with age-matched control subjects, with a prevalence of 43.48% in the femoroacetabular impingement group compared with 12.77% in the control group (P=.0012). On the 4-point Likert scale, the average severity of osteitis pubis in the group with femoroacetabular impingement was 1.5 (minimal to mild) compared with 0.53 (no osteitis pubis to minimal findings) in the control population. This significant increase in osteitis pubis in patients with femoroacetabular impingement supports the clinical link between these 2 processes. [Orthopedics. 2016; 39(3):e417-e422.].