Skeletal Radiology

, Volume 34, Issue 11, pp 691–701 | Cite as

Imaging findings of femoroacetabular impingement syndrome

  • Douglas P. Beall
  • Clifford F. Sweet
  • Hal D. Martin
  • Craig L. Lastine
  • David E. Grayson
  • Justin Q. Ly
  • Jon R. FishEmail author
Review Article


Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement—cam impingement and pincer impingement—are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients’ symptoms.


Musculoskeletal radiology Hip Conventional radiography Magnetic resonance Anatomy 


  1. 1.
    Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop 1999; 363:93–99.CrossRefPubMedGoogle Scholar
  2. 2.
    Ito K, Minka MA II, Leunig M, Werlen S, Ganz R. Femoracetabular impingement and the cam-effect: an MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 2001; 83:171–176.CrossRefPubMedGoogle Scholar
  3. 3.
    Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 2002; 84:556–560.CrossRefPubMedGoogle Scholar
  4. 4.
    Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. J Bone Joint Surg Br 2003; 85:278–286.Google Scholar
  5. 5.
    Kim YT, Azuma H. The nerve endings of the acetabular rim. Clin Orthop 1995; 320:176–181.Google Scholar
  6. 6.
    Harris H. Harris Hip Score. J Bone Joint Surg Am 1969; 51:737–755.PubMedGoogle Scholar
  7. 7.
    Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br 1991; 73:423–429.PubMedGoogle Scholar
  8. 8.
    Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular Impingement. Clin Orthop 2003;417:112–120.PubMedGoogle Scholar
  9. 9.
    Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br 1999; 81:281–288.CrossRefPubMedGoogle Scholar
  10. 10.
    Tonnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 1999; 81:1747–1770.PubMedGoogle Scholar
  11. 11.
    Goodman DA, Feighan JE, Smith AD, et. al. Subclinical slipped capital femoral epiphysis. J Bone Joint Surg Am 1997; 79:1489–1497.PubMedGoogle Scholar
  12. 12.
    Leunig M, Beck M, Woo A, Dora C, Kerboull M, Ganz R. Acetabular rim degeneration: a constant finding in the aged hip. Clin Orthop 2003; 413:201–207.Google Scholar
  13. 13.
    Eijer H, Myers SR, Ganz R. Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma 2001; 15:475–481.CrossRefPubMedGoogle Scholar
  14. 14.
    Daenen B, Preidler KW, Padmanabhan S, et al. Symptomatic herniation pits of the femoral neck: anatomic and clinical study. AJR Am J Roentgenol 1997; 168:149–153.PubMedGoogle Scholar
  15. 15.
    Leunig M, Werlen S, Ungersbock A, Ito K, Ganz R. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg Br 1997; 79:230–234.CrossRefPubMedGoogle Scholar
  16. 16.
    Schmid MR, Notzli HP, Zanetti M, et al. Cartilage lesions in the hip: diagnostic effectiveness of MR arthrography. Radiology 2003; 226:382–386.Google Scholar
  17. 17.
    Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R, Siebenrock KA. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage 2003; 11:508–518.CrossRefPubMedGoogle Scholar
  18. 18.
    Snow SW, Keret D, Scarangella S, Bowen JR. Anterior impingement of the femoral head: a late phenomenon of Legg-Calve-Perthes’ disease. J Pediatr Orthop 1993; 13:286–289.PubMedGoogle Scholar
  19. 19.
    Harris WH, Bourne RB, Oh I. Intra-articular acetabular labrum: a possible etiological factor in certain cases of OA of the hip. J Bone Joint Surg Am 1979; 61:510–514.PubMedGoogle Scholar
  20. 20.
    Stulberg SD, Cordell LD, Harris WH, Ramsey PL, McEwen GD. Unrecognized childhood hip disease: a major cause of idiopathic OA of the hip. In: Proceedings of the 3rd meeting of the Hip Society. St Louis: CV Mosby, 1975:212–228.Google Scholar
  21. 21.
    Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement. I. Techniques of joint preserving surgery. Clin Orthop 2004; 418:61–66.PubMedGoogle Scholar

Copyright information

© ISS 2005

Authors and Affiliations

  • Douglas P. Beall
    • 1
  • Clifford F. Sweet
    • 1
  • Hal D. Martin
    • 1
  • Craig L. Lastine
    • 1
  • David E. Grayson
    • 1
  • Justin Q. Ly
    • 1
  • Jon R. Fish
    • 1
    Email author
  1. 1.Department of Radiologal SciencesUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA

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