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From the center of the femoral head, a second line is drawn to the point where the superior surface of the head–neck junction first departs from the circle.Cam impingement is characterized by abnormal contact between the proximal femur and acetabulum caused by a non-spherical femoral head, known as a cam deformity.A cam deformity is usually quantified by the alpha angle; greater alpha angles substantially increase the risk for osteoarthritis (OA).A cam deformity is commonly assessed by the alpha angle, which measures the extent to which the femoral head deviates from spherical.However, there is neither a validated alpha angle threshold value to define the presence of a cam deformity, nor a pathological threshold that indicates an increased risk for development of OA.The Chingford cohort is a population-based cohort of 1003 asymptomatic women aged 44–67 years (mean 54.2 years) at baseline.

These women were registered at a general practice in London and were invited to participate in a study assessing musculoskeletal disease in the population.

Alpha angle thresholds of 60° to define the presence of a cam deformity and 78° for a pathological cam deformity are proposed.

Historically, the cause of most hip osteoarthritis (OA) has been defined as ‘idiopathic’, but recent evidence suggests that development of hip OA is largely influenced by the presence of a cam deformity83°) at baseline and subsequent development of end-stage OA after 5 years.

Yearly clinic visits were performed, which included; morphometric, clinical, biologic, and radiographic measurements.

In the CHECK study, weight-bearing Anterio-Posterior (AP) pelvis radiographs were obtained from the 11 participating research centers according to a standardized protocol, taken at baseline and at 2 and 5 years follow-up.

A small sand bag under the knees was used to minimize hip rotation.