MRI FOR FAI HIP PAIN (does it tell the whole truth?)

MY STORY:

I recently had an Xray of my right hip that told me I have:

Broad sub-capital neck / increased convexity of femoral head (commonly called “cam impingement”)
Subcondral cysts
Possible labral damage

Needless to say, even though I have NO symptoms or pain of FAI hip impingement…I was still a bit shaken up and scared!

I got this MRI after having previously gotten an Xray:

GETTING AN MRI:

A few weeks after the X-ray, I got an MRI to confirm the finding and investigate if there were any labral concerns as well. The findings were:

Cam Impingement confirmed
Paralabral Cyst / Labral Tear
Risk of increasing labral damage as I age
Risk of Degenerative arthritis

But here's the kicker...the last finding revealed that:
5. “Myotendinous structures” (adductors / rectus femoris) were NORMAL

CONCLUSION FOR ME:
“Bad bones” + Healthy Muscles = happy, pain-free hips!

DISCUSSION:

So what is “the truth” about imaging for FAI hip problems?

The truth is…its complicated! The human body is complicated!

We are not lifeless anatomy models whose parts can just be sliced and diced without potential repercussions, nor can we ignore the detailed and effective work we can do with the muscular system to free up a restricted joint!

IMPORTANT POINT #1 (IF YOU’VE ALREADY HAD SURGERY):

The reality that muscles (texture, ROM, and motor control) can eliminate hip pain and dysfunction is equally true if you’ve already had surgery for FAI but are struggling with the PT (Physical Therapy) and rehabilitation that is necessary even after surgery. You can still address the muscles in a more effective way than you might be doing!

IMPORTANT POINT #2 (THE VALUE IN IMAGING):

I am NOT saying that Xrays and MRI’s are useless. I’m just stating that the don’t paint a clear and comprehensive picture.

Your body is a complex “system of systems,” and many factors affect its function and sensation (pain or no pain). X-rays and MRIs can possibly tell you what you might be predisposed to, but they are not a death sentence if you have some kind of bony “abnormality.”