The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 1: overview

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Clinical management of femoroacetabular impingement (FAI) syndrome lacks evidence-based guidance, leading to practice variability.
• Expert consensus is crucial for standardizing FAI imaging assessment.

Purpose of the Study:

• To establish expert-based statements on FAI imaging using formal consensus-building techniques.
• To reduce variability in clinical practices and guide future research in FAI management.

Main Methods:

• A validated Delphi method involving 30 international experts (radiologists and surgeons).
• Literature review and iterative rounds of statement agreement scoring (0-10).
• Classification of 44 questions into five topics: General issues, Parameters, Radiography, MRI, and Ultrasound.

Main Results:

• Forty-seven statements were generated, with consensus achieved for 45 (95.7%).
• Seventeen key statements were selected for dissemination.
• No consensus was reached for statements regarding Ultrasound.

Conclusions:

• Radiographic evaluation, including AP pelvis and Dunn 45° views, is fundamental for hip assessment.
• MRI with a dedicated protocol is the gold standard for FAI imaging.
• The consensus provides a tool to standardize FAI imaging and inform research.