The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 3: imaging techniques

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Femoroacetabular impingement (FAI) diagnosis lacks high-level evidence, causing management variability.
• Optimizing imaging protocols for FAI is crucial but challenging in clinical practice.

Purpose of the Study:

• To establish expert-based statements on FAI imaging through formal consensus techniques.
• Provide recommendations for imaging techniques and classifications in FAI assessment.

Main Methods:

• The Delphi method involved 30 experts (radiologists, orthopedic surgeons) over 4 rounds.
• Consensus was reached on 47 statements derived from literature review and expert scoring.

Main Results:

• Consensus was achieved for 45 out of 47 statements.
• Key consensus areas include radiographic assessment (8 statements) and MRI evaluation (12 statements).
• No consensus was reached for ultrasound-related statements.

Conclusions:

• The first international consensus on FAI imaging has been developed.
• Recommendations support evidence-based imaging protocols and classifications for FAI.
• Radiography is recommended for initial assessment; MRI is the gold standard for comprehensive evaluation.