Presentation
Painful hip movements bilaterally.
Patient Data
Osseous bump at the femoral head-neck junctions, and short femoral neck bilaterally; giving the pistol grip deformity appearance.
Features consistent with bilateral femoroacetabular impingement, cam type.
Pistol-grip deformity (Arrows) with epiphyseal scar (Yellow dotted line) which extends lateral to a best fit circle of the femoral head also known as “horizontal growth plate sign" seen in cam femoroacetabular impingement.
Case Discussion
Femoroacetabular impingement is characterized by abnormal contact between the proximal femur and rim of the acetabulum. It affects typically healthy, active adults, between 25 and 50 years. Cam lesions are more common in young males.
Cam impingement is a result of a non-spherical head causing abnormal contact stresses.
In most cases, the proximal femoral malformation is idiopathic. It also can be a sequela of childhood disease, including SCFE or any hip in which the femoral neck is too large.
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