Bony morphology of the hip in professional ballet dancers compared to athletes

Susan Mayes, April Rose Ferris, Peter Smith, Andrew Garnham, Jill Cook

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Objectives: To compare hip bony morphology between ballet dancers and a sporting control group and to determine the relationship with hip pain. Methods: Thirty-three professional ballet dancers and 33 age- and sex-matched athletes completed questionnaires, including the Copenhagen Hip and Groin Outcome Score (HAGOS), and underwent clinical testing and 3.0-T magnetic resonance imaging to measure acetabular coverage with lateral centre edge angles, femoral head-neck junction concavity with alpha angles at anterior and superior positions, femoral neck-shaft angles, and acetabular version angles. Results: Bony morphological measures fell within normal ranges. Dancers had higher neck-shaft angles (dancers 134.6 ± 4.6°/athletes130.8 ± 4.7°, p = 0.002), lower acetabular version angles (13.5 ± 4.7°/17.1 ± 4.7°, p = 0.003), lower superior alpha angles (38.9 ± 6.9°/46.7 ± 10.6°, p < 0.001), similar anterior alpha angles (43.6 ± 8.1/46 ± 7°, p = 0.2), and similar lateral centre edge angles (28.8 ± 4.6°/30.8 ± 4.5°, p = 0.07) compared to athletes. Abnormal morphology was detected in dancers: 3% acetabular dysplasia (athletes 0), 15% borderline dysplasia (6%), 24% cam morphology (33%), 24% coxa valga (6%), and 21% acetabular retroversion (18%). The HAGOS pain scores correlated moderately with acetabular version (r = -0.43, p = 0.02) in dancers, with no other correlation between pain and morphological parameters in either group. Conclusions: Professional ballet dancers have hip bony morphology that differentiates them from athletes. Hip pain correlated poorly with bony morphology. Key points: • Ballet dancers have hip bony morphology that may allow extreme hip motion. • Morphological parameter means fell within normal reference intervals in dancers. • Bony morphology correlates poorly with hip pain. • The risk of hip injury due to abnormal morphology requires prospective studies.

Original languageEnglish
Pages (from-to)3042-3049
Number of pages8
JournalEuropean Radiology
Volume27
Issue number7
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • Acetabular dysplasia
  • Acetabular version
  • Femoroacetabular impingement
  • Hip pain
  • Neck-shaft angle

Cite this

Mayes, Susan ; Ferris, April Rose ; Smith, Peter ; Garnham, Andrew ; Cook, Jill. / Bony morphology of the hip in professional ballet dancers compared to athletes. In: European Radiology. 2017 ; Vol. 27, No. 7. pp. 3042-3049.
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abstract = "Objectives: To compare hip bony morphology between ballet dancers and a sporting control group and to determine the relationship with hip pain. Methods: Thirty-three professional ballet dancers and 33 age- and sex-matched athletes completed questionnaires, including the Copenhagen Hip and Groin Outcome Score (HAGOS), and underwent clinical testing and 3.0-T magnetic resonance imaging to measure acetabular coverage with lateral centre edge angles, femoral head-neck junction concavity with alpha angles at anterior and superior positions, femoral neck-shaft angles, and acetabular version angles. Results: Bony morphological measures fell within normal ranges. Dancers had higher neck-shaft angles (dancers 134.6 ± 4.6°/athletes130.8 ± 4.7°, p = 0.002), lower acetabular version angles (13.5 ± 4.7°/17.1 ± 4.7°, p = 0.003), lower superior alpha angles (38.9 ± 6.9°/46.7 ± 10.6°, p < 0.001), similar anterior alpha angles (43.6 ± 8.1/46 ± 7°, p = 0.2), and similar lateral centre edge angles (28.8 ± 4.6°/30.8 ± 4.5°, p = 0.07) compared to athletes. Abnormal morphology was detected in dancers: 3{\%} acetabular dysplasia (athletes 0), 15{\%} borderline dysplasia (6{\%}), 24{\%} cam morphology (33{\%}), 24{\%} coxa valga (6{\%}), and 21{\%} acetabular retroversion (18{\%}). The HAGOS pain scores correlated moderately with acetabular version (r = -0.43, p = 0.02) in dancers, with no other correlation between pain and morphological parameters in either group. Conclusions: Professional ballet dancers have hip bony morphology that differentiates them from athletes. Hip pain correlated poorly with bony morphology. Key points: • Ballet dancers have hip bony morphology that may allow extreme hip motion. • Morphological parameter means fell within normal reference intervals in dancers. • Bony morphology correlates poorly with hip pain. • The risk of hip injury due to abnormal morphology requires prospective studies.",
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Bony morphology of the hip in professional ballet dancers compared to athletes. / Mayes, Susan; Ferris, April Rose; Smith, Peter; Garnham, Andrew; Cook, Jill.

In: European Radiology, Vol. 27, No. 7, 01.07.2017, p. 3042-3049.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - Objectives: To compare hip bony morphology between ballet dancers and a sporting control group and to determine the relationship with hip pain. Methods: Thirty-three professional ballet dancers and 33 age- and sex-matched athletes completed questionnaires, including the Copenhagen Hip and Groin Outcome Score (HAGOS), and underwent clinical testing and 3.0-T magnetic resonance imaging to measure acetabular coverage with lateral centre edge angles, femoral head-neck junction concavity with alpha angles at anterior and superior positions, femoral neck-shaft angles, and acetabular version angles. Results: Bony morphological measures fell within normal ranges. Dancers had higher neck-shaft angles (dancers 134.6 ± 4.6°/athletes130.8 ± 4.7°, p = 0.002), lower acetabular version angles (13.5 ± 4.7°/17.1 ± 4.7°, p = 0.003), lower superior alpha angles (38.9 ± 6.9°/46.7 ± 10.6°, p < 0.001), similar anterior alpha angles (43.6 ± 8.1/46 ± 7°, p = 0.2), and similar lateral centre edge angles (28.8 ± 4.6°/30.8 ± 4.5°, p = 0.07) compared to athletes. Abnormal morphology was detected in dancers: 3% acetabular dysplasia (athletes 0), 15% borderline dysplasia (6%), 24% cam morphology (33%), 24% coxa valga (6%), and 21% acetabular retroversion (18%). The HAGOS pain scores correlated moderately with acetabular version (r = -0.43, p = 0.02) in dancers, with no other correlation between pain and morphological parameters in either group. Conclusions: Professional ballet dancers have hip bony morphology that differentiates them from athletes. Hip pain correlated poorly with bony morphology. Key points: • Ballet dancers have hip bony morphology that may allow extreme hip motion. • Morphological parameter means fell within normal reference intervals in dancers. • Bony morphology correlates poorly with hip pain. • The risk of hip injury due to abnormal morphology requires prospective studies.

AB - Objectives: To compare hip bony morphology between ballet dancers and a sporting control group and to determine the relationship with hip pain. Methods: Thirty-three professional ballet dancers and 33 age- and sex-matched athletes completed questionnaires, including the Copenhagen Hip and Groin Outcome Score (HAGOS), and underwent clinical testing and 3.0-T magnetic resonance imaging to measure acetabular coverage with lateral centre edge angles, femoral head-neck junction concavity with alpha angles at anterior and superior positions, femoral neck-shaft angles, and acetabular version angles. Results: Bony morphological measures fell within normal ranges. Dancers had higher neck-shaft angles (dancers 134.6 ± 4.6°/athletes130.8 ± 4.7°, p = 0.002), lower acetabular version angles (13.5 ± 4.7°/17.1 ± 4.7°, p = 0.003), lower superior alpha angles (38.9 ± 6.9°/46.7 ± 10.6°, p < 0.001), similar anterior alpha angles (43.6 ± 8.1/46 ± 7°, p = 0.2), and similar lateral centre edge angles (28.8 ± 4.6°/30.8 ± 4.5°, p = 0.07) compared to athletes. Abnormal morphology was detected in dancers: 3% acetabular dysplasia (athletes 0), 15% borderline dysplasia (6%), 24% cam morphology (33%), 24% coxa valga (6%), and 21% acetabular retroversion (18%). The HAGOS pain scores correlated moderately with acetabular version (r = -0.43, p = 0.02) in dancers, with no other correlation between pain and morphological parameters in either group. Conclusions: Professional ballet dancers have hip bony morphology that differentiates them from athletes. Hip pain correlated poorly with bony morphology. Key points: • Ballet dancers have hip bony morphology that may allow extreme hip motion. • Morphological parameter means fell within normal reference intervals in dancers. • Bony morphology correlates poorly with hip pain. • The risk of hip injury due to abnormal morphology requires prospective studies.

KW - Acetabular dysplasia

KW - Acetabular version

KW - Femoroacetabular impingement

KW - Hip pain

KW - Neck-shaft angle

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