Advanced Imaging

The Lisbon agreement recommends using standard radiographs for initial assessment and magnetic resonance imaging (MRI) as the gold standard for imaging of femoroacetabular impingement (FAI). Computed tomography (CT) is controversial due to radiation dose and is recommended mainly for complex cases. MR imaging techniques have advanced, providing higher image quality and detailed assessments, including quantitative imaging. Radial imaging of the femur is crucial for optimal delineation of deformities like cam deformity. MR arthrography is superior to conventional MRI for assessing labral tears and cartilage damage, with the use of contrast fluid improving the delineation of structures. Ultrasound is valuable for soft tissue evaluation around the hip, with dynamic ultrasound proving useful for identifying sources of pain pre- and postoperatively.