Crossover sign

Case contributed by Dr Robert Foley

Presentation

Painful left hip for five months. High energy dancer, movements are full but painful.

Patient Data

Age: 20 years
Gender: Male
X-ray

No fracture. Both hip joints are normal and symmetrical.

Bilateral crossover signs are demonstrated (indicative of acetabular retroversion).

Annotated image

Zoomed radiograph of the right hip. The image on the right is annotated to illustrate the anterior acetabular wall (red line) and posterior acetabular wall (blue line). The crossover is present if these two lines intersect, indicating acetabular retroversion.

Case Discussion

The crossover sign has been implicated in pincer-type femoroacetabular impingement and is thought to be a pre-disposing factor for osteoarthritis 1. This patient is suffering from hip pain, which may or may not be related to his previous trauma. He may have acetabular retroversion and be at risk of osteoarthritis, which is why it is important to think of and recognize this sign. 

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Case information

rID: 69934
Published: 30th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: University Hospitals Bristol

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