Current RMA Instruments
| 3 of 2026 | |
| 4 of 2026 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Codes: M25.85, Q65.8
Brief description
Femoroacetabular impingement syndrome (FAIS) is a disorder of the hip seen predominantly in young and middle aged adults. It occurs when abnormal contact between the femoral head-neck junction and the acetabulum leads to repetitive joint damage. The main clinical features are actively-related hip or groin pain (which may also be felt around the lateral hip or in the lower back) and reduced range of hip movement.
Confirming the diagnosis
Diagnosing femoroacetabular impingement syndrome involves a clinical presentation suggesting abnormal contact between the femoral head-neck function and the acetabulum during hip motion. This requires a practitioner's assessment of symptoms- typically motion-related or position-related hip or groin pain- and examination findings consistent with impingement.
To confirm the diagnosis, imaging must demonstrate abnormal morphology at the hip joint, such as cam or pincer features, that can account for the impingement. this is usually identified on X-ray, CT or MRI. If imaging does not show morphology consistent with impingement, the diagnosis cannot be confirmed. Management often involves an orthopaedic surgeon. However, general practitioners may confirm the diagnosis when supported by consistent clinical findings and appropriate imaging findings.
Additional diagnoses that are covered by SOP
- Developmental or congenital morphology such as cam or pincer features, including mild hip dysplasia, may contribute to femoroacetabular impingement. These are anatomical variants rather than separate diseases or injuries and generally should not be treated as a separate diagnosis. When relevant, they can be included within the diagnostic label for FAIS- e.g. Right femoroacetabular impingement with cam morphology.
Conditions that may be covered by the SOP
Non-traumatic (degenerative) labral tears are common findings on CT or MRI of the hip. They may:
- Occur as part of femoroacetabular impingement syndrome
- represent an incidental, clinically insignificant finding, or
- be seen as part of early osteoarthritis
When a degenerative labral tear occurs in the context of FAIS, it may be included in the overall diagnostic description- e.g. Right hip femoroacetabular impingement with degenerative labral tear.
As a general principle, a degenerative labral tear alone should not be diagnosed as a standalone condition.
Conditions that are excluded from SOP
- Chondral defect of the hip joint * - acute articular cartilage tear SOP
- Degenerative labral tear associated with osteoarthritis of the hip * - osteoarthritis SOP
- Osteoarthritis of the hip *
- Traumatic labral tear of the hip * - labral tear SOP
* another SOP applies - the SOP has the same name unless otherwise specified
Clinical onset
The clinical onset refers to the earliest point in time, as identified by the treating doctor, when symptoms or signs consistent with femoroacetabular impingement syndrome were first observed. The primary early feature is motion-related or position-related pain felt in the hip or groin, although pain may also be experienced in the buttock, lower back or thigh. Additional early indicators may include clicking, catching, stiffness, a sense of giving way, or reduced range of hip motion. These findings occur prior to the diagnosis being confirmed through imaging.
Clinical worsening
When assessing potential clinical worsening, it is important to determine whether any increase in symptoms is beyond what would normally be expected from the natural course of FAIS. Symptoms may fluctuate with activity levels, often improving when hip movements at the extremes of range are avoided and recurring when such activities are resumed.
Clinical worsening may be evidenced by a sustained increase in pain, stiffness, or loss of function despite appropriate conservative management such as physiotherapy. Surgical intervention may be considered in selected cases. The development of osteoarthritis in the affected hip, represents a new onset of osteoarthritis, rather than a worsening of femoroacetabular impingement syndrome. Assessment by an orthopaedic surgeon should be sought to consider whether true clinical worsening has occurred.