The Warwick Agreement on the femoroacetabular impingement syndrome (FAIS) is an attempt to standardize the diagnostic criteria for this condition. This is characterized by an abnormal contact between the proximal femur and the acetabulum. The meeting involved 25 clinical societies from around the world.


Triad for the diagnosis of the FAIS - all of the following:

(1) clinical symptoms

(2) findings on the clinical examination

(3) positive imaging findings


Clinical symptoms include:

(1) motion or position related groin pain

(2) motion or position related lateral hip or buttock pain

(3) locking or catching

(4) clicking

(5) giving way

(6) restricted range of motion

(7) stiffness


The clinical exam may show:

(1) an abnormal gait

(2) reduced hip muscle strength

(3) variable change in range of motion, especially restricted internal rotation in flexion

(4) pain on hip impingement (flexion adduction internal rotation)

(5) pain relief with local anesthetic injection


Imaging studies may show:

(1) acetabular retroversion (pincer impingement refers to a deep or retroverted acetabulum)

(2) femoral retroversion

(3) increased lateral center edge angle

(4) cam deformity (aspherical femoral head or presence of additional bone at the femoral head-neck junction)


Any one of these features may be present without clinical progression to FAIS. All three need to be considered when making the diagnosis.


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