This study aimed to evaluate the relationship between the radiographical features of combination of the acetabular coverage and the femoral head-neck shape and the occurrence of femoroacetabular impingement (FAI). In this study, 114 patients who had FAI with or without labral tear and mild osteoarthritis were analyzed. Plain radiographs and computed tomography (CT) were taken for evaluation of acetabular coverage and femoral head-neck measurements. The relationship between the combination angle of acetabular coverage and femoral head-neck measurements and the occurrence of FAI was evaluated. The prevalence of FAI patients with the combination angle of CT-anterior CE + α angle ≥100° was 6.1% (7/114 patients). Receiver operator characteristic curve analysis demonstrated a higher area under the curve for combination of CT-anterior center edge angle (ACEA) with the α angle at 0.94 (CT-ACEA +α angle). A threshold for the occurrence of FAI was determined using the combination CT-ACEA + α angle at 100°. The frequency of FAI surgery was significantly higher in patients with a combination angle ≥100° than in those with a smaller angle. The average modified Harris hip score was significantly lower in patients with a combination angle ≥100° than in those with a smaller angle. We suggest that the combination of lateral center edge angle ≥40°, α angle ≥50° and combined angles of CT-ACEA and α angle ≥100° may help diagnosis of FAI. Level of evidence III: retrospective cohort study.
