Cam morphology found in 48% of adolescent and young adult athletes with FAI syndrome
Photo by Mishaal Zahed (Meschael Zahède) / Unsplash
Key Takeaway
Interpret cam and pincer prevalence estimates cautiously due to inconsistent diagnostic methods and limited data on symptoms and sex.
This systematic review with meta-analysis examined the prevalence of cam and pincer morphologies in adolescent (ages 10-19 years) and young adult (ages 20-35 years) athletes with femoroacetabular impingement (FAI) syndrome. The analysis included 1241 adolescents and 2462 young adults from multiple studies.
The pooled prevalence of cam morphology was 48% (95% CI: 38, 58) and pincer morphology was 18% (95% CI: 7, 32). Notably, prevalence did not differ between adolescent and young adult age groups for either morphology.
The authors note several limitations: few studies stratified findings by symptomatic state, few reported findings in females, and diagnostic methods were inconsistent across studies. These factors limit the generalizability and clinical applicability of the results.
Clinicians should interpret these prevalence estimates cautiously given the heterogeneity in diagnostic approaches and the lack of stratification by symptoms or sex. Further research with standardized imaging and clinical assessment is needed to clarify the role of these morphologies in FAI syndrome among young athletes.
View Original Abstract ↓
To (1) examine the prevalence of cam and pincer morphologies in adolescent (ages 10-19 years) and young adult (ages 20-35 years) athletes, and (2) summarize diagnostic imaging and clinical assessment methods associated with femoroacetabular impingement (FAI) syndrome. Epidemiology systematic review with meta-analysis. The MEDLINE, Embase, SPORTDiscus, CINAHL, and Scopus databases were searched to February 2025. English studies reporting on prevalence of FAI syndrome morphologies, whether symptomatic or not, in male/female athletes (10-35 years) were eligible. Studies were excluded if they focused on adapted or parasports or included participants who had undergone corrective surgery. Two independent raters conducted screening, extracted data, and assessed quality/risk of bias. Meta-analyses were performed for cam and pincer morphology prevalence, stratified by age group. Methods of clinical assessment and diagnostic imaging were descriptively reported. The primary analysis compared morphologies between adolescent and young adult athletes with subgroup (hip vs participant) and factor (sex) analyses. Forty-seven studies reporting on 1241 adolescents (16% female) and 2462 young adults (20% female) were included. Primary analysis estimates for the prevalence of cam morphology (48%; 95% confidence interval [CI]: 38, 58) and pincer morphology (18%; 95% CI: 7, 32) indicated no difference between age groups. Many studies (n = 17, 35%) assessed FAI syndrome according to Warwick recommendations (signs, symptoms, imaging). Few studies stratified findings by symptomatic state. Cam morphology appeared to develop in early adolescence. Few studies reported findings in females, and diagnostic methods were inconsistent. .
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