Despite his family history of FAI, the initial working diagnosis was different than FAI. It was interesting that patient had other family members diagnosed of FAI in the past and it turned out to be the same diagnosis in his case as well. Corrective treatment of which helped to control his symptoms permanently.
Corrective surgery for CAM lesion and subsequent physical therapy.
His hip pain significantly improved after the corrective surgery. He was able to return back to sports pain free in few weeks of post-operative physical therapy.
Hip pain due to FAI is common in athletic populations. Current literature is not clear about the exact time when the pathogenesis of this problem starts but it was rare and very interesting to find this problem running in the family.
This case posed a clinical challenge in that the patients symptoms could have been due to either the FAI or femoral neck stress fracture. It was clearly the appropriate step to treat the patient for the femoral neck stress fracture initially since that has the higher risk of acute morbidity. FAI in young adolescents has been reported and surgical intervention can produce good results (Phillippon, et al). The early age of onset suggests a genetic predisposition and further study of a genetic link is warranted.
Philippon, Marc J., et al. Early Outcomes After Hip Arthroscopy for Femoroacetabular Impingement in the Athletic Adolescent Patient: A Preliminary Report. Journal of Pediatric Orthopaedics:
October/November 2008 - Volume 28 - Issue 7 - pp 705-710
James Daniels, MD MPH Program Director Southern Illinois University Primary Care Sports Medicine Fellowship Program
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