Femoroacetabular Impingement Diagnosis and Examination

Primary Clinical Examination Findings

Groin pain is the hallmark symptom of Femoroacetabular Impingement (FAI) syndrome, though pain may also radiate to the back, buttock, or thigh, as noted by the British Journal of Sports Medicine 1
The FADIR (Flexion-Adduction-Internal Rotation) test has good sensitivity but poor specificity for diagnosing FAI syndrome, making it better at ruling out FAI when negative than confirming it when positive, according to the British Journal of Sports Medicine 1
Pain at end-range hip flexion combined with rotation is characteristic of FAI syndrome, as reported by the British Journal of Sports Medicine 1

The FABER (Flexion-Abduction-External Rotation) test, also known as the Patrick test, has lower diagnostic precision compared to the FADIR test, as stated by the British Journal of Sports Medicine 2

Physical examination alone has limited diagnostic utility for FAI syndrome, and clinical examination tests cannot definitively distinguish FAI syndrome from other causes of hip-related pain, as emphasized by the British Journal of Sports Medicine 1
Most clinical tests demonstrate good sensitivity but poor specificity, highlighting the need for a comprehensive approach combining symptoms, clinical signs, and imaging findings for proper diagnosis, as recommended by the British Journal of Sports Medicine 1

In adolescents, it is essential to rule out slipped capital femoral epiphysis (SCFE), Perthes disease, infection, tumors, and fractures when examining for FAI, as noted by the British Journal of Sports Medicine and Praxis Medical Insights 1, 3
The absence of groin pain helps exclude FAI syndrome and labral tears, according to the British Journal of Sports Medicine 1
Consider referred pain from the spine or knee as alternative sources, as suggested by the Journal of the American College of Radiology 4

Plain radiographs showing cam morphology (alpha angle >60°) or pincer morphology (lateral center edge angle >40°) can aid in the diagnosis of FAI, as reported by the British Journal of Sports Medicine 2
The diagnosis of FAI requires the triad of symptoms, clinical signs, and imaging findings, as stated by the British Journal of Sports Medicine 1