Examining Symptoms, Clinical, and Radiographic Signs of Femoroacetabular Impingement Syndrome in Youth Ice Hockey and Ringette Athletes, Part 2: A Cross-Sectional Study

Objectives: (1) To radiographically examine morphologies consistent with femoroacetabular impingement (FAI) syndrome in youth ice hockey and ringette athletes aged 14 to 24 years; (2) to examine FAI syndrome diagnosis because it relates to positive findings on special tests. Design: Cross-sectional. Setting: University, Sport Medicine Center. Participants: Male and female ice hockey/ringette athletes at 14 to 24 years with no history of traumatic hip/pelvic injuries/surgeries. Interventions: Examination of a novel screening protocol, using a cluster of tests, for FAI syndrome. Main Outcome Measures: Clinical hip findings (hip passive range of motion [p-ROM]; hip muscle strength testing; hip impingement special tests [ST]), radiographic evidence of FAI syndrome (α angle; lateral center edge angle [LCEA]; crossover sign). Results: A convenience sample of 28 males and 30 females consented from a larger cohort to undergo radiographs. FAI syndrome was present in 61% of males and 67% of females. Males demonstrated higher odds of cam morphologies unilaterally relative to females (OR = 4.29, 95% CI, 1.52–12.23), and based on point estimates, females displayed higher odds of pincer morphologies, both unilaterally (OR = 2.68, 95% CI, 0.95–7.73) and bilaterally (OR = 2.41, 95% CI, 0.73–8.12). Males displayed higher α angle than females (b 2 = 6.05, 95% CI, −9.75 to −2.34). No other covariates were associated with α angle/LCEA. With each additional positive ST, the odds of having evidence of FAI syndrome increased 3-fold (OR = 3.34, 95% CI, 1.91–5.83). Conclusions: Youth male and female ice hockey and ringette athletes display similar prevalence of FAI syndrome; however, specific morphologies differ by sex. This study provides evidence that a cluster of tests may increase the certainty with which suspected FAI syndrome can be assessed through screening.