Hip cam and pincer lesions are terms used to describe structural abnormalities of the hip joint that can contribute to hip pain and, in some cases, may increase the risk of hip osteoarthritis. These lesions are associated with a condition known as femoroacetabular impingement (FAI), which can cause hip pain, limited range of motion, and, over time, joint damage. Here’s an overview of cam and pincer lesions:
- Cam Lesion:
- Definition: A cam lesion is characterized by an abnormality in the shape of the femoral head (the round end of the thigh bone or femur) or the neck of the femur. Instead of being perfectly spherical, the femoral head may have an aspherical or “bump-like” shape.
- Mechanism: Cam lesions often result from an overgrowth of bone at the front or top of the femoral head or neck. This non-spherical shape can cause abnormal contact and friction within the hip joint.
- Symptoms: Cam lesions can lead to hip pain, particularly during activities that involve flexing the hip, such as squatting or running. Over time, this can contribute to hip cartilage damage and early-onset osteoarthritis.
- Pincer Lesion:
- Definition: A pincer lesion involves an abnormality on the acetabulum (the socket of the hip joint), typically characterized by excessive coverage or a prominent bony ridge. This extra bony structure can cause impingement when the femoral head moves within the hip socket.
- Mechanism: Pincer lesions often result from excessive growth or shape abnormalities of the acetabulum, which can lead to pinching or “impingement” of the labrum (a ring of cartilage that surrounds the hip socket) and the femoral head.
- Symptoms: Pincer lesions can also cause hip pain and discomfort, especially during activities that involve hip flexion or rotation. They may contribute to labral tears and cartilage damage in the hip joint.
- Diagnosis: Diagnosis of cam and pincer lesions typically involves:
- Physical examination to assess hip range of motion, pain, and function.
- Imaging studies, such as X-rays, MRI, or CT scans, to visualize the hip joint and identify structural abnormalities.
- Treatment:
- Conservative Management: Initial treatment often includes rest, activity modification, physical therapy to improve hip strength and flexibility, and anti-inflammatory medications to alleviate pain and inflammation.
- Surgical Intervention: In cases where conservative treatments do not provide sufficient relief, surgical procedures may be considered. These can involve reshaping the femoral head or acetabulum to correct the structural abnormalities and relieve impingement. Surgical intervention may also be necessary if there is significant cartilage or labral damage.
- Hip Preservation: Some individuals with cam and pincer lesions may undergo hip preservation procedures to prevent or delay the onset of osteoarthritis.