FAI Hip Impingement (Femoro-acetabular Impingement)

FAI Hip Impingement Awareness facts - It is estimated that approximately 15% of the young, adult population have hip impingement, so who do you know that might have it?
Hip impingement causes painful labral tears within the hip socket.
Hip FAI symptoms are misleading to the average medical professional, as FAI hip impingement pain frequently presents as low back pain and interesting only 10% of back pain is ever clinically diagnosed and cured... Which begs the question what percentage is actually caused by hip FAI or hip impingement, as its otherwise known.
The more active you are, the more likely you are to trigger hip impingement symptoms, so busy mums and gym bunnies beware... but at least you're in good company as many premiere league football players have also suffered FAI hip pain.
Hip impingement is diagnosed through x-ray and labral tears are diagnosed through MRI arthograms - but both need to be read by hip consultants specifically trained in FAI hip impingement.
There are 60,000 hip replacements every year in the UK and it now appears that FAI hip impingement, over the years, could be the leading cause of hip osteoarthritis. A silent epidemic.
Hip arthroscopy can reduce the hip impingement and reattach the torn labrum to the hip socket. This surgery can eliminate the pain and disability caused by FAI hip impingement and divert the need for hip replacement in later life.


Also please feel welcome to join in our help and advice forum for support. We have 3 advising FAI expert hip surgeons, 3 PT/physios and a sports medicine doctor as well as the largest international FAI hip impingement forum on the net:

Thursday, 1 April 2010

Appointment with the consultant

Saw Professor Schilders yesterday.
Whats its not:
He thinks its not arthritis as on X-ray there looks to still be good distance within the socket and in surgery whilst there was a wave sign, the arthritis was categorized as grade 2, mild.
He says its not coxa - profunda? (big sockets) as I still have a teardrop sign. I didn't think it was though.
He says that there is retroversion because of the crossover sign, but says that its not, in his experience, the problem and that in arthroscopy he had a good view of my posterior socket and it was problem free. So the retroversion is mild.
He said it was not posterior impingement and I insisted on a physical test for that, which he did and it was pain free. He also said that again, during surgery no visible damage was there at the posterior hip capsule.

What it could be:
He said, according to his stats, pain could be caused by scar tissue. My only real bug bear with Proff Schilders, is that I feel he prefers to use his history stats, rather than listen to the individual. I'm sure he does both.. but I do feel like saying 'there's no point referring to your stats, as I'm never the average!'

I also showed one way I can illicit the pain, by laying on my side with my right leg on top, causing it to fall into an internal rotation. This made him say it was possible that there could be some residual impingement.

My question though its if its caused by scar tissue, which builds with time, why did the pain never go away and then return? It simply stayed, which has my money on residual impingement.

Alternatively the problem could be tendons etc.

So the inevitable arrived, the best test to rule in or out my actual hip socket was an anesthetic injection into my hip joint, yay! Actually for the 1st time in four of these, it actually hurt!

Anyhow, afterwards my sit pain disappeared, which I wasn't expecting, as once before I had the same shot and the sit pain didn't disappear.... so I wonder.. It could still be my hip causing all this pain. I could also more clearly feel other factors at play like a really tight, sore hamstring and a bit of discomfort around the SI, but these weren't that all encompassing pain and with that gone, I think I was able to distinguish other niggles. Does that sound weird?
Also where and when I would feel pain (like sitting) instead I simply felt like a deep itch that couldn't be reached, but not pain. I wonder too, if that's normal?

So this morning I need to know 2 things, could any anesthetic go into the local muscles, as that could skew the consequence of no pain on sitting after a hip socket injection and did he give me a stronger shot of anesthetic, so that this time it could stop the pain?
I feel a phone call to his secretary coming on!

ps The anesthetic should've lasted 5 to 6 hours, but felt to last 3 to 4 before the pain broke back through.

PPS We exchanged on our house yesterday, yippee so its legal and on May 10th I can move out of this stair hell, though lovely house, and move to my easy stair house!!

PPPS Note to self, the marker pen they use to draw all over your hip, prior to injection, doesn't just wash off.. not even with a shower.. and exfoliater. Might delay swimming, as it looks like I've been drawn up for liposuction!

3 comments:

  1. Hey Loiusa,

    yay to the house exchange that's great news and not long to wait at all..

    It does sound (in my unqualified medical opinion) like there is some residual impingement. The deep itch sounds like you would expect if the anaesthetic had numbed the pain but you would imagine there would still be some sensation of something if there is a lot of inflammation.

    Have you decided what to do next or do you feel any further forward ?

    Dee

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  2. Plod on I guess as my Gran would say!
    MRA and Ithink I should maybe insist on CT too and then action... but for my own peace of mind I think I'll get a second opinion too from Villars, even if I go back to Schilders for op. Thanks for asking X Glad your THR working out so well for you.

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  3. you're welcome !! hope the house move/packing goes OK and try (easier said than done I know) not to overdo it. I think you're right re a second opinion as at the very least you will get another perspective. I think def push for a CT as things can show there that wouldn't appear on the MRA.

    I'm not an overly gushy person but I feel very fortunate to be pain free in the left hip since the THR and don't know that I'll ever take my mobility for granted again. I wish a pain free existence for you too as it's wonderful.

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