Femoroacetabular Impingement
Load-bearing, training overuse, and post-traumatic mechanisms driving femoroacetabular impingement and hip osteoarthritis in service members.
38 CFR diagnostic codes 5250, 5251, 5252, 5253, 5254, 5255
Peer-reviewed evidence · 8 studies
Every one links to its record
Scher DL, Belmont PJ Jr, Mountcastle S, Owens BD. The incidence of primary hip osteoarthritis in active duty US military servicemembers. Arthritis Rheum. 2009;61(4):468-75. PMID:19333991. doi:10.1002/art.24429.
PMID 19333991Check the record (opens in a new tab)Williams TR, Puckett ML, Denison G, Shin AY, Gorman JD. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings. Skeletal Radiol. 2002;31(5):277-81. PMID:11981604. doi:10.1007/s00256-002-0485-0.
PMID 11981604Check the record (opens in a new tab)Kuhn KM, Riccio AI, Saldua NS, Cassidy J. Acetabular retroversion in military recruits with femoral neck stress fractures. Clin Orthop Relat Res. 2010;468(3):846-51. PMID:19588210. doi:10.1007/s11999-009-0969-5.
PMID 19588210Check the record (opens in a new tab)
Key facts
- Diagnostic codes
- 5250, 5251, 5252, 5253, 5254, 5255
- Verified studies
- 8
- Legal theories
- Direct (§ 3.303)
Peer-reviewed evidence (8)
The verified studies behind a Femoroacetabular Impingement claim — each links to its real PubMed or DOI record. These are sources our nexus drafts can draw from; none are invented.
- Scher DL, Belmont PJ Jr, Mountcastle S, Owens BD. The incidence of primary hip osteoarthritis in active duty US military servicemembers. Arthritis Rheum. 2009;61(4):468-75. PMID:19333991. doi:10.1002/art.24429.
- Williams TR, Puckett ML, Denison G, Shin AY, Gorman JD. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings. Skeletal Radiol. 2002;31(5):277-81. PMID:11981604. doi:10.1007/s00256-002-0485-0.
- Kuhn KM, Riccio AI, Saldua NS, Cassidy J. Acetabular retroversion in military recruits with femoral neck stress fractures. Clin Orthop Relat Res. 2010;468(3):846-51. PMID:19588210. doi:10.1007/s11999-009-0969-5.
- Barkley C, Wong WK, Knapik JJ, Westrick RB. The Presence of Hip Joint Effusion on MRI Is Predictive of a Grade 4 Femoral Neck Stress Injury. Mil Med. 2023;188(7-8):e1828-e1834. PMID:36611263. doi:10.1093/milmed/usac347.
- Jorgensen AY, Waterman BR, Hsiao MS, Belmont PJ. Functional outcomes of hip arthroplasty in active duty military service members. J Surg Orthop Adv. 2013;22(1):16-22. PMID:23449050. doi:10.3113/jsoa.2013.0016.
- Thomas DD, Bernhardson AS, Bernstein E, Dewing CB. Hip Arthroscopy for Femoroacetabular Impingement in a Military Population. Am J Sports Med. 2017;45(14):3298-3304. PMID:28937803. doi:10.1177/0363546517726984.
- Jochimsen KN, Jacobs CA, Duncan ST. Femoroacetabular impingement is more common in military veterans with end-stage hip osteoarthritis than civilian patients: a retrospective case control study. Mil Med Res. 2019;6(1):27. PMID:31439033. doi:10.1186/s40779-019-0218-5.
- Hillery BL, Goldman AH, Velosky AG, Amoako MY, Leggit JC, Highland KB. Time to Total Hip Arthroplasty Among Patients in the US Military Health System. JAMA Netw Open. 2025;8(10):e2539971. PMID:41148135. doi:10.1001/jamanetworkopen.2025.39971.
Controlling law
The CFR sections and cases the theories relevant to this condition rest on — the legal standard raters evaluate against, never a prediction about any claim.
Direct (§ 3.303)
Regulation
38 C.F.R. § 3.303
Direct service connection — a current disability linked to service. (Continuity of symptomatology under § 3.303(b) is limited by case law to the § 3.309(a) chronic diseases — Walker.)
Case law
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004)
The three-element test: current disability, in-service event, and a nexus between them.
Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009)
Federal Circuit restatement of the same three direct-service-connection elements.
Caluza v. Brown, 7 Vet. App. 498 (1995)
The evidentiary framework a rater weighs each element against.
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)
Continuity of symptomatology (§ 3.303(b)) is available ONLY for a chronic disease listed in § 3.309(a); any other condition must use the medical-nexus pathway.
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009)
A categorical 'a medical opinion is always required for nexus' is legal error — competent lay evidence can suffice.
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994)
A veteran is competent to report symptoms they personally observe (Layno), and lay evidence can even establish a simple diagnosis in the right case (Jandreau).
McLendon v. Nicholson, 20 Vet. App. 79 (2006)
A LOW threshold — evidence that merely indicates a nexus MAY exist obligates VA to provide a C&P exam.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
Related guides & tools
Build your Femoroacetabular Impingement documentation
Generate and review your claim documents free — grounded in sources like these. When you want the nexus opinion signed, a licensed provider can review and sign it.
Educational information about the evidentiary standard — not legal or medical advice, and never a prediction about any claim.