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Cam acetabular impingement syndrome

*What is Cam Impingement?* Cam impingement, also known as Cam morphology, is a type of femoroacetabular impingement (FAI) where there is an abnormality in the shape of the femoral head. Instead of being perfectly round, the femoral head has an aspherical or "bump" on its anterolateral aspect (the front and outer side). *How Does it Cause Pain?* During hip flexion (like squatting, running, or even just sitting), this bump on the femoral head *abnormally contacts the acetabular rim*. This repetitive, abnormal contact leads to: 1. *Cartilage Damage:* The labrum (a fibrocartilaginous ring that stabilizes the hip joint) gets pinched and torn. This is where most of the pain comes from. 2. **Osseous Changes**: Over time, the bone in the acetabulum starts reacting to the abnormal pressures and the bone around the acetabular rim can become sclerotic (hardened) and sometimes cystic. 3. *Osteoarthritis:* Over many years, untreated Cam impingement can lead to premature osteoarthritis of the hip. *Who Gets Cam Impingement?* Young, active adults (20s-40s): More common in males. Athletes: Especially those involved in sports requiring repetitive hip flexion and rotation (e.g., soccer, hockey, running). People with certain skeletal conditions: Occasionally, Cam morphology can be associated with developmental hip dysplasia or other skeletal abnormalities. *Radiographic Findings* *X-ray:* Aspherical Femoral Head: This is the key finding. Look for a loss of the normal round contour of the femoral head, especially on the anterolateral aspect. Pistol Grip Deformity: In more severe cases, the femoral head may appear flattened, resembling the handle of a pistol.