Tuba ERDEM SULTANOĞLU, Sarfinaz ATAOĞLU, Hasan Baki ALTINSOY, Hasan SULTANOĞLU

Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar

Amaç: Çalışmamızda femoroasetabular sıkışma sendromlu hastalarda klinik sonuçların ve eşlik edebilen pelvik bölgedeki radyolojik değişikliklerin incelenmesi; kalça ağrılarının etyolojisinde femoroasetabular sıkışmanın ve konservatif tedavinin öneminin vurgulanması amaçlanmıştır. Gereç ve Yöntem: Ağustos 2016-Ağustos 2020 tarihleri arasında femoroasetabular sıkışma sendromu tanısı olan 104 hastanın dosya kayıtları ile sosyodemografik ve klinik özellikleri, abdominal ve pelvik bilgisayarlı tomografi taramaları, pelvik bölgenin magnetik rezonans görüntülemeleri retrospektif olarak incelendi. Bulgular: Hastaların %41.3’ü kadın, %58.7’si erkek ve yaş ortalaması 52.78±13.18 idi. Hastaların %37.5’u ev hanımı; %29.8’i çalışmayan; %28.8’i çalışan ve %3.8‘i öğrenciydi. Kalça ağrısı olan hastaların oranı %76 idi. %31.7’sinde sağ kalça; %22.1 sol kalça ve %22.1’inde her iki kalça bölgesinde ağrı şikayeti mevcuttu. Hastaların %17.3’üne aktivite modifikasyonu ve medikal tedavi; %32.7’sinde medikal tedavi ve ev egzersiz programı; %26.0’ünde fizyoterapi uygulanmış; %24.0'ünde herhangi bir tedavi uygulanmamıştı. Hastaların %54.8’ine tomografi; %45.2’sine magnetik rezonans görüntüleme ile tanı konmuştu. Radyografik bulgulara göre %80.8’inde cam tip; %5.8’inde pincer tip ve 13.5’inde mikst tip femoroasetabular sıkışma vardı. Asemptomatik hastaların %53.7’sinde; ağrı şikayeti olan hastaların %61.8’inde pelvik bölgede ek radyolojik değişiklikler vardı. Her iki grupta pelvik bölgede eşlik eden radyolojik değişiklikler en fazla subkortikal kist ve sklerozdu. Sonuç: Kalça osteoartriti gelişiminde önemli faktörlerden birisi olan femoroasetabular sıkışma sendromu kalça ağrısı nedenleri araştırılırken düşünülmelidir. Erken tanı ve etkin tedaviyle kalça ekleminin korunması, hastanın yaşam kalitesinin arttırılması hedeflenmelidir. Bu amaçlarla fizyoterapi semptomatik femoroasetabular sıkışma sendromlu hastalarda tedavi seçeneği olarak düşünülebilir.

Anahtar Kelimeler:

Femoroasetabuler sıkışma, pelvik ağrı, tanısal görüntüleme, konservatif tedavi

Radiologic abnormalities of pelvic area and clinical outcomes in patients with femoroacetabular ımpingement syndrome

Aim: In our study, we aimed to examine the clinical outcomes and radiological changes in the pelvic region in patients with femoroacetabular impingement syndrome; to emphasize the importance of femoroacetabular impingement in the etiology of hip pain and conservatif management. Material and Methods: The sociodemographic and clinical characteristics, abdominal and pelvic computed tomography scans, pelvic magnetic resonance imaging of 104 patients diagnosed with femoroacetabular impingement syndrome between August 2016-August 2020 were retrospectively analyzed.Results: 41.3% of the patients were female, 58.7% were male and the mean age was 52.78 ± 13.18. 37.5% of the patients are housewives; 29.8% are not working; 28.8% were working and 3.8% were students. The proportion of patients with hip pain was 76%. 31.7% had pain in the right hip; 22.1% had pain in the left hip and 22.1% in both hip regions. Activity modification and medical therapy for 17.3% of the patients; medical treatment and home exercise program in 32.7%; physiotherapy was applied in 26.0%; no treatment was applied in 24.0%. 54.8% of the patients were diagnosed by tomography and 45.2% of them were diagnosed by magnetic resonance imaging. According to radiological results, 80.8% of them had cam; 5.8% had pincer and 13.5% had mixed type of femoroacetabular impingement. In 53.7% of asymptomatic patients and in 61.8% of the patients with pain complaints had additional radiological changes in the pelvic region. Accompanying radiological changes in the pelvic region were mostly subcortical cysts and sclerosis. Conclusion: Femoroacetabular impingement syndrome, which is one of the important factors in the development of hip osteoarthritis, should be considered when investigating the causes of hip pain. Protection of the hip joint and increasing the patient's quality of life should be aimed with early diagnosis and effective treatment. For these purposes, physiotherapy can be considered as a treatment option in patients with symptomatic femoroacetabular impingement syndrome

Keywords:

Femoroacetabular impingement, pelvic pain, diagnostic imaging, conservative treatment,

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