A 37-year-old male presented with 4 months of atraumatic left hip pain. Onset of symptoms began during basic military training and pain was exacerbated by physical activity. Plain film radiographs of the hip were reported as normal. Because of the concern for a potential stress fracture, the patient was referred to nuclear medicine for bone scintigraphy. Planar and SPECT imaging revealed the presence of abnormal scintigraphic activity involving both hips (left greater than right) in a distribution atypical for stress injury and more consistent with bilateral femoral acetabular impingement (FAI). Subsequent MR examination was confirmed the diagnosis. This case illustrates a novel method for evaluating the physiologic process of FAI.