IADMS New York 2002   [back to the Category]

Pistol-Grip Deformity of the Femoral Neck ......   [read the french version]

Author :   Roger Hobden, MD

Pistol-Grip Deformity of the Femoral Neck:
A Predictor of Mechanical Impingement at the Hip Joint
in the Professional Dancer and Dance Student


Roger Hobden, MD
Department of Family Medicine, University of Montreal
Montreal, Quebec, Canada


Pistol-grip deformity of the femoral neck is present in approximately 8% of the population. It’s prevalence in the dance population is presently unknown. This condition has been described in the scientific literature under various names including femoral head tilt-deformity, post-slip deformity, retroversion and subclinical slipped capital femoral epiphysis. Due to it’s mechanical effects on the hip joint, this syndrome may lead to intermittent pain in the anterior groin area when dance movements involve lifting the leg at 90 degrees and higher. The deformity of the femoral head and neck that defines this syndrome can lead to labral tears and eventually premature osteoarthritis of the hip joint on the affected side. Clinical diagnosis can be suspected when a sharp pain is reproduced by a combination of flexion, adduction and internal rotation of the hip joint.

The clinical significance of the X-Ray findings are often currently downplayed by many radiologists. These findings may include osteophyte formation, sclerosis, denting of the bony surface, perilabral cysts and stress fractures (misdiagnosed as “os acetabulum”). Surprisingly, more sophisticated investigative measures such as magnetic resonance with arthrography will not necessarily add more information to that given by plain and frog view X-Rays of the hip joint. Health professionals treating dancers need to be aware of this syndrome and it’s implications for the diagnosis and treatment of hip pain. Clinical cases of dance students or professional dancers will be presented illustrating clinical and radiological diagnosis and treatment strategies for this condition.