PMC3445188_01
Hip pain differential diagnosis flow chart used in examination. ER, external rotation; PROM, passive range of motion; IR, internal rotation; ROM, range of motion; FAI, femoroacetabular impingement; MRA, magnetic resonance imaging arthrogram.
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The lumbar/pelvic girdle examination led to a focus on the hip joint (Figure 1).
Three-dimensional computed tomography scan image illustrates the cam lesion (arrows).
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Right hip radiography, magnetic resonance imaging arthrogram (MRA), and 3-dimensional computed tomography suggested pincer impingement with cam lesion (Figure 2) and a tear of the superior labrum.
Anterior portal view of labrum and grade III chondromalacia. Viewing the right hip from the anterolateral portal, a probe is introduced from the anterior portal. The labrum (white asterisk) is intact, without evidence of pathologic pincer impingement. Grade III chondromalacia of the adjacent acetabular surface (black asterisk) indicates damage from cam impingement.
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Articular cartilage breakdown of the anterolateral acetabulum was seen (grade III; Figure 3) with cam-type impingement.