• Anteroposterior (AP) views of both hips should be obtained on a single film with the beam centered over the femoral heads. Care should be taken to ensure appropriate pelvic tilt and avoid pelvic rotation. Lateral center-edge angles can be measured to assess lateral acetabular coverage.

• On false profile views of both hips, anterior coverage can be evaluated by measuring an anterior center-edge angle.

• Frog-leg lateral, cross-table lateral, or modified Dunn lateral views have all been used to assess femoral head-neck offset, but many cam lesions can still be missed.

• Figure 1 shows AP (Fig. 1A) and frog-leg lateral (Fig. 1B) views of the pelvis in a 28-year-old male with cam- and pincer-type femoroacetabular impingement. Note the decrease in femoral head-neck offset, the large cam deformity, and the right rim fracture caused by impingement.

• diGEMRIC MRI is the best imaging study to evaluate the soft tissues of the hip, including the labrum, ligamentum teres, and extracapsular musculature.

• diGEMRIC sequences are especially useful for evaluating the health of the articular cartilage and identifying chondral flaps.

• Radial cuts taken circumferentially around the femoral head and neck allow better identification of subtle cam lesions. In a 20-year-old female with right hip pain, a plain AP radiograph is somewhat suggestive of a cam deformity, but the findings are subtle (Fig. 2A). Radial sequence MRI of the same hip, however, clearly shows the cam morphology (Fig. 2B).

• We prefer the use of a pegboard, but other positioning aids are equally effective.

• The proximal extent of the incision is just distal to the iliac crest, and the distal end of the incision is 6–8 cm past the vastus ridge. The average incision length is 20–25 cm.

• The Gibson approach starts with a straight incision centered over the anterior third of the greater trochanter (Fig. 5).

• Alternatively, the cephalad limb of the incision can be curved posteriorly for the Kocher-Langenback approach.