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:

Sunday, 30 May 2010

All MRI's are not equal, getting the best

In short I'm having a pretty crappy time with regards to hips - both hips are down now! Same symptoms too on both sides, groin pain on walking and some movements, groin and bum pain on sitting, lots of muscle strain feelings in TFL, IT band, ab/adductors, hamstrings, the works with cherrries on top! The tipping point was moving house 2 weeks ago! The irony!!

I am now waiting on an MRI arthogram appointment for my right (post op) hip to see what gives. I will then see what the radiologist and my consultant say. If it is obviously scar tissue, then the course of action is simple, well, simple if I forget the fear of surgery and nightmare of childcare! If its not scar tissue, then.... then I'll cross that bridge when I come to it - huh, get me all Yoda!!

I also want a second opinion, either way, to make absolutely sure retrovertion of the acetabulum is not an issue, as I still obviously have concerns and feel I need that answered clearly, absolutely and NOT finger in the windly!!!

I need some resolution and I need it soon. I have had this diagnosis a year now (though symptoms coming up for almost 7) and I was pretty sure when the diagnosis was handed out to me by that by last Christmas, 09, that it would all be behind me (both hips)... but not one hip is resolved as yet, SUPER disappointing!

So, lets see what this MRI/A brings.

Also a tip, there are different strengths of MRI scanner, they ARE NOT all the same at all. They are measured in tesla strengths and that determines the level of detail which can be seen.

0.3T - might as well take your clothes off and ask them to see through you!

0.5T

1T - average

1.5T

2T

3T - best

I was scheduled a scan with a 1T MRI at the Yorkshire Clinic and have cancelled and phoned around the country and found a 3T MRI scanner. Ironically its not in a private hospital, or far away, but at Chapel Allerton, an NHS hospital in Leeds.
I am doing all I can to get that an appointment here, but its not easy as I am a private patient, but Bupa won't cover this NHS hospital, despite its superior facilities.
I had to explain all this to my GP, who I lost within the first sentence discussing the pros and cons of 1 verses 3 tesla MRI field strengths, God only knows what she writes in my notes nowadays?!

Anyway there's a lot to be said for determination and I figure no more messing about and no ones sticking a needle injections into my hip socket again for anything less than a 3T scanner!

Good luck hippies, the saga DRAAAAGGGS on as so often these hip-mares do!

12 comments:

  1. Hi louisa,

    Just been reading through all your blogs regarding your surgery and its good to read someone elses point's who has been operated on by professor schilders.

    Professor Schilders did my op on 10/05/2010 but at this point i'm wishing i'd never even gone into hospital, maybe i'm rushin into sayin that as i'm still on crutches for another week but the pain is worse than before and from reading your blogs it doesnt sound like it improves quickily.

    Just wondering did you ever have days where you thought the pain had gone or was it always there because as a male with this problem i'm gettin pains in certain places (blushes) and i honestly dont think i can stick it anymore.

    Sorry to everyone if it sounds like i'm moanin but i do know i'm lucky as i have been seen after 2 1/2 years of havin this pain and after reading i have noticed people have waited years. Like yourself i'm in two minds if to have my right hip done.

    any advice or information would be great.

    Kind Regards


    John

    ReplyDelete
  2. Hi John, so sorry to hear you are in pain.. it sounds as though your pain isn't been managed correctly by your GP, what are you taking and is it enough?
    What did you have done?
    To be honest I was in a bit less pain for the first 6 weeks, but I think that was a mixture of pain meds and rest (as ever with this, rest and it eases off)
    My pain came back more when I came off crutches and started to weight bear..
    I would say its very early days and he does appear to have very good success rates in general, although up until last month I think he put me in his success's, so I'm not sure!

    I think you may need more of different pain medication to get you into a better place.. have you called Rachel his secretary, she is wonderfully helpful and speaks to many recovering patients, she got me through many dark days.

    My physio has referred many to Schilders so far I think 10 this year, I think I am the only one not to recover, lucky me!

    Will you keep in touch.

    ReplyDelete
  3. Hi lousia,

    thnk you for such a quick reply. I am on 30mg codeine 3 times a day (2 tablets) Yes maybe your right still early to judge and just getting bit uptight as i'm used to been out and workin all time so just a big change of life for past few weeks espc at 23 feel bir stupid when people ask what i have had done.

    Its defo worse when i do weight baring but mainly when i'm sat in a car or sat upright on the sofa then the pain is intense and straight to certain points!!!

    I didnt go private which i think i'm going to consider for next treatment but couldn't fault B.R.I at all they we're really good and even food was nice (didn't stay down long though due to the morphine)

    In terms of my surgery i had a FAI,Chondral damage and labral tears which caused afew loose bodies aswell.

    Hope to hear from yourself in the future and nice in a way to hear/read stories from other hip suffers!!

    ReplyDelete
  4. Hi John,
    Take anti inflams too, surprised you haven't been prescribed them... they help with limiting the development of scar tissue, I stopped mine after a week or so, as they didn't agree with my stomach and didn't know about all the research backing up how they stunt scar tissue forming.
    It is mind numbing the time out, I'm a busy Mum of two under 5's and in a former life before this FAI stopped me sitting, was a busy journalist too and pretty active always.. and yes I HATED the pitying stares etc, almost got to the point of wearing a fake pot on my foot and saying I was injured sky diving or something non geriatric!
    I had terrible pain in bum and bit groin on sitting, that never left for me though, which is why I thought mine hadn't worked from the beginning. It makes everything difficult work and socially.
    Have you seen the facebook FAI sites? The understanding FAI is fantastic for meeting like minded or symptomatic people and hip blogs (FAI, PAO, THR) Great for access to some of the best hip blogs around.
    OS why go private if BRI good, don't waste your money, Schilders is Schilders whereever he is, plus the night staff doctor I encountered far from inspired confidence in the event of an incident, at Yorks Clinic... and I had to pay £30 cash for crutches and £14 meds to leave with.. I think they put a bar code on your bum when private!

    ReplyDelete
  5. Hey Louisa, following the MRA at The Yorkshire which diagnosed my labral tear I was asked to volunteer in a study on hip scans. I went to Chapel Allerton and had my hip scanned - they were trying to prove that you could get all the same info as an MRA with a super strength MRI with no injection.
    They could also produce a 3D image of the hips that you could journey through. It was amazing!
    Unfortunately you could not use the images for diagnostics (thats why they asked my after I had already had the official scan) and so that they could compare the results.
    Don't know if that helps you at all but if you contact me I can give you the number of the person who phoned my up to include me in the study.

    Cx

    ReplyDelete
  6. Claire yes please and thank you so much!

    ReplyDelete
  7. Hi Louisa,
    I came across your blog while doing a google search on this surgery. I was set to have it done on 24 May 2010, but my insurance company denied it. I am now back on the schedule after a couple of weeks of fighting with insurance. I have been having this pain for years and am ready to have the surgery, but am a little scared. Every time I see someone's post about recovery in a bad light, I tell my husband that my pain and restrictions can not get any worse. So, my question to you is if you had to do it all over again knowing what you do now, would you still go through with the surgery? Thanks so much for your very informative blog and pics.

    ReplyDelete
  8. OOh tricky one Kacey, as I am not fully recovered.. so I could regret it.. BUT, as I had lost the ability to walk anywhere or sit for anytime I feel it'd got so far that I had no choice and I am improved. I can carry my HEAVY daughter, lay on my front sleeping and have generally more tolerance...its like I have been set back 4 out of the 6 or so years as it crept upon me.

    My biggest wish is that I had been diagnosed sooner and had the op much earlier.

    I guess I will be better qualified to say what I think after my second MRI, in so far that if its just scar tissue, then I will go back fix that and should be happily on my way..
    If its remaining bony impingement then I have to have a serious convo with my consultant, because it should've been completed at the time.

    My advice would be, if truly honest, you have no choice but to have surgery at some time or face serious disability in time.. the questions for you possibly could be 'when do you do it' and 'who does it'.. and they are things to seriously think about.

    So sorry not to sound less final, but it will not go away by itself and will continue to damage you hip. REally hope that helps in some way Kacie and if its any comfort, I started my blog around the same time as about 10 other, they're all recovered and my physio found at least 12 others this year, also post op, all recovered.
    There will be more negatives on the net, because if you're doing well theres nothing to say.
    Have you been on the facebook FAI site support group called 'understanding hip impingement FAI,' super facility, you'll meet loads of people the same there.
    Wishing you luck.

    ReplyDelete
  9. Hi Louisa,

    I've been reading your blogs for the past few weeks. I had a labral repair and hip debridement for FAI on May 19. My recovery is going well so far (knock wood), but I wanted to thank you for providing so many points of reference and places for information! You've really helped me stay sane through the long days of recovery. I decided to start my own blog - better late than never - and added it to your Facebook page. I hope that's ok!

    I certainly hope you get to the bottom of your pain. It must be terribly wearing to have to deal with this day in and day out after all the effort you've put into your recovery. Good luck with your second opinion - I definitely agree that one is in order!

    ReplyDelete
  10. Thanks Jen,
    I'm really glad to hear you're doing so well.. I'll have to have a peak at your blog too and thanks for adding it to the facebook blogs where people can access it, that is fab thank you!

    ReplyDelete
  11. Thanks so much for answering my question. You are completely correct in all the information I have found on the web is negative. I will check out the support group on Facebook. I have my surgery next Wednesday, 23 June. Again, thank you for all the information your blog has provided.

    ReplyDelete
  12. Hi Louisa,

    How are things going with you? ave you had the scan yet or seen Schilders again?
    My good hip has gone bad and therefore am struggling with both as the PAOd one doesn't like having to do more than its share.
    Email me at cat@broughzoo.karoo.co.uk if you want, would love to hear how things are going for you, still not got around to facebook.
    Kate xx

    ReplyDelete