无论股骨髋臼撞击综合征与髋关节发育不良的诊断如何，坐姿疼痛比站立疼痛更常见

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI:10.1016/j.asmr.2025.101116

Matthew J. Kraeutler M.D. , Brian Q. Nguyen B.A. , Carson Keeter M.S. , Kyle S.J. Jamar B.S. , Kristian Samuelsson M.D., Ph.D. , Jessica H. Lee M.D. , Omer Mei-Dan M.D.

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引用次数: 0

摘要

目的探讨坐位髋部疼痛与站立髋部疼痛之间的可能相关性，以及股髋臼撞击综合征（FAIS）与髋关节发育不良的初步诊断。方法：从2023年9月开始，所有到髋关节保护诊所就诊的新患者都被前瞻性地询问：“长时间坐着还是站着，你的髋关节疼痛更严重吗？”患者根据主要诊断分为两组：FAIS或髋关节发育不良。初步诊断基于病史、体格检查和影像学检查。伴有FAIS和发育不良的患者，如果建议行髋臼周围截骨术（PAO），则可初步诊断为发育不良，但同时伴有发育不良和较大cam病变的患者除外。进行逻辑回归分析，以确定是否有任何变量与坐着与站立髋关节疼痛显著相关。结果共纳入115例患者（118髋），其中男性30例，女性88例。FAIS和髋关节发育不良分别为71例和47例。初次就诊的平均年龄为34岁。总体而言，无论诊断如何，坐姿疼痛(n = 74；62.7%, 95% CI 53.7-70.9)比站立性髋关节疼痛更容易发生(n = 44；37.3%, 95% ci 29.1-46.3)。没有证据表明FAIS组和髋关节发育不良组在经历坐姿和站立髋关节疼痛的几率上有差异（P = 0.85）。也没有证据表明年龄、性别、外侧中心边缘角度、股骨扭转角或α角与经历坐姿疼痛和站立疼痛的几率有关。结论无论诊断为FAIS还是髋关节发育不良，坐姿疼痛都比站立疼痛更常见，没有证据表明FAI/坐姿疼痛与髋关节发育不良/站立疼痛之间存在关联。证据水平：II级，连续系列诊断研究。

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Sitting Pain Is More Common Than Standing Hip Pain Regardless of Diagnosis of Femoroacetabular Impingement Syndrome Versus Hip Dysplasia: A Prospective Comparative Study

Purpose

To explore a possible correlation between sitting versus standing hip pain and a primary diagnosis of femoroacetabular impingement syndrome (FAIS) versus hip dysplasia.

Methods

All new patients presenting to a hip preservation clinic starting in September 2023 were prospectively asked, “Do you have more hip pain with sitting or standing for a long time?” Patients were divided into two groups based on primary diagnosis: FAIS or hip dysplasia. Primary diagnosis was based on a combination of history, physical examination, and imaging. Patients with concomitant FAIS and dysplasia were given a primary diagnosis of dysplasia if they were recommended to undergo a periacetabular osteotomy (PAO), although patients with concomitant dysplasia and a large cam lesion were excluded. Logistic regression analysis was performed to determine if any variables were significantly associated with sitting versus standing hip pain.

Results

A total of 115 patients (118 hips) were included (30 male, 88 female). FAIS and hip dysplasia were the diagnoses in 71 and 47 hips, respectively. Mean age at initial presentation was 34 years. Overall, regardless of diagnosis, sitting pain (n = 74; 62.7%, 95% CI 53.7-70.9) was found to be more likely than standing hip pain (n = 44; 37.3%, 95% CI 29.1-46.3). There was no evidence of a difference in the odds of experiencing sitting versus standing hip pain between the FAIS and hip dysplasia groups (P = .85). There was also no evidence that age, sex, lateral center edge angle, femoral torsion angle, or alpha angle contribute to the odds of experiencing sitting versus standing pain.

Conclusions

Sitting pain is more common than standing pain regardless of diagnosis of FAIS versus hip dysplasia, with no evidence of an association between FAI/sitting pain and dysplasia/standing pain.