Bilateral cam femoroacetabular impingement: the case of a Nanbudo athlete self-referral to physiotherapy

Leoni, Diego Maria (2014) Bilateral cam femoroacetabular impingement: the case of a Nanbudo athlete self-referral to physiotherapy. In: Diego Maria 4° Congresso Nazionale SIF, 24-25 May 2014, Firenze, Italy.

Slideshow FAI Case Study_Congresso SIF 2014.pdf - Published Version Download (8MB)

Abstract

Aim: This case report describes the physiotherapy management of a self-referral patient with bilateral groin pain and unlcear prognosis Background: Femoroacetabular impingement (FAI), sport’s hernia, pubic bone injuries, nerve entrapment, psoas tendon and adductor muscles’s lesions, are typical causes of groin pain. Cam FAI derives from a prominence of the femoral neck which, forcing into the acetabulum, results in a labrum tear or avulsion. Anamnesis, negativity to clinical tests for other conditions, and positivity to the anterior impingement test (AIT) suggest the hypothesis of Cam FAI. The diagnosis is confirmed with an antero-posterior X-ray of the pelvis. Case description: A 40 years old male beginner Nanbudo athlete presented with a bilateral groin pain. Pain started two weeks before after training with high kicks, so that he stopped training. At the moment pain occurred during fast walking, walking uphill and coming out of the car. Five months before similar symptoms completely regressed after two weeks of rest. Physical examination didn’t revealed any RoM restrictions, muscle weakness or paraesthesia. The cough impulse test was negative. No pubic tubercles, psoas tendon or adductor muscles tenderness was found. Hip muscles testing and passive movements were negative for pain provocation except hip flexion, slightly painful. The AIT (Fig 1A) was positive bilaterally and evoked patient’s complain. Intervention: Hypothesizing a reversible anterior hip joint tissues overload, a two-weeks low-intensity short-wave local diathermy treatment was planned, combined with functional rest. Since the symptoms didn’t regressed the treatment was stopped and in agreement with the medical doctor an X-rays performed. Any bone lesion was detected but a bilateral “pistol-grip deformity” (Fig 1B) was found. An arthro-MRI was then performed and a bilateral anterosuperior labrum tear was diagnosed. Patient undertook an arthroscopic intervention with femoral neck resection (Fig 1C) and debritment of the labrum tears. Then physiotherapy for RoM recovery and muscle reconditioning was carried out. Four months after surgery the patient came back training Nanbudo without pain. Conclusions: FAI early recognition allows to prevent irreversible articular tissues damages. Differential diagnosis skills including referral to medical doctors when necessary, are strongly recommended to physiotherapists to properly manage self-referral patients.

Item Type:	Article in conference proceedings or Presentation at a conference (Speech)
Uncontrolled Keywords:	femoroacetabular impingement, groin pain, differential diagnosis, sel-referral patient
Subjects:	Subjects Allied to Medicine > Anatomy, physiology & pathology > Physiotherapy
Department/unit:	Dipartimento economia aziendale, sanità e sociale > Laboratorio di ricerca in riabilitazione
Depositing User:	Diego Leoni
Date Deposited:	06 May 2015 09:34
Last Modified:	14 May 2021 11:00
URI:	http://repository.supsi.ch/id/eprint/6494

Actions (login required)

View Item