EP6.19 CT imaging findings in symptomatic FAI: A Systematic Review
Bibliographic record
Abstract
Abstract Background: Femoroacetabular impingement (FAI) is a leading cause of hip pain in young adults and a cause of osteoarthritis. Despite the prevalence of FAI, patients often experience delays in diagnosis and variable use of CT imaging in their diagnostic testing. Purpose: To conduct a systematic review on FAI patients to examine which CT radiographic values are most closely associated with symptom development and poorer outcomes to identify the key CT findings that can increase timely diagnosis and accurate treatment expectations. Methods: We screened PubMed, SCOPUS, OVID Medline, Embase, Cochrane Central Register of Clinical Trials, and clinicaltrials.gov for literature on CT morphology in FAI. Patient demographics, CT data, intraoperative findings, and patient reported outcomes were recorded. An assessment of each paper’s quality was assessed with the Newcastle-Ottawa Scale and only papers scoring >7 points (“good” quality) were included in our systematic review. Results: 21 studies with 1,503 hips at an average of 38.4 years were included in this systematic review. 52.7% were female and average BMI was 25.11 Kg/m2. Five studies reported follow-up at minimum 1 or 2 years, and four studies reported intraoperative findings. Thirteen studies reported alpha angles. Eight studies reported lateral center edge angles (LCEA), with two studies reporting significant differences compared to mean in pincer morphology. Fourteen studies reported acetabulum morphology, ten studies reported femoral morphology, and two studies reported pelvic tilt. Alpha angles, specifically between the 1 o’clock and 2 o’clock position on the femoral clockface, were consistently significantly greater in symptomatic cam-FAI compared to asymptomatic cam morphology and controls. Three of four studies reporting femoral neck-shaft angle found significantly lower angles in symptomatic cam-FAI compared to asymptomatic cam morphology and controls. Conclusion: Greater cam deformity was associated with greater extent of labral tearing and worse postsurgical patient reported outcomes when coupled with location near 1:30 o’clock on the femoral clockface. Symptomatic cam-FAI demonstrated lower femoral head-neck angles compared to asymptomatic hips that otherwise had cam morphology. Greater LCEA in pincer morphology was associated with worse postsurgical patient reported outcomes. These three CT radiographic data have diagnostic and prognostic value for FAI patients across multiple studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".