Hip joint pathology: relationship between patient history, physical tests, and arthroscopy findings in clinical practice

The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18–65 y...

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Bibliographic Details
Published in:Scandinavian journal of medicine & science in sports 2017-03, Vol.27 (3), p.342-350
Main Authors: Tijssen, M., Cingel, R. E. H., Visser, E., Hölmich, P., Nijhuis‐van der Sanden, M. W. G.
Format: Article
Language:English
Subjects:
Adult
Arthroscopy
clinical assessment
Cohort Studies
diagnostic accuracy
Diagnostic tests
examination
Female
Femoracetabular Impingement - diagnosis
Femoracetabular Impingement - physiopathology
Femoracetabular Impingement - surgery
Hip
Hip joint
Hip Joint - physiopathology
Hip Joint - surgery
Humans
Male
Middle Aged
Pathology
Physical Examination
Range of Motion, Articular - physiology
Retrospective Studies
Sensitivity and Specificity
Sports medicine
Young Adult
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Summary:The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18–65 years) were included if they were referred to a physical therapist to gather pre‐operative data and were then diagnosed during arthroscopy. Results of pre‐operative patient history and physical tests were collected and compared to arthroscopy. Data of 77 active patients (mean age: 37 years) were included. Groin as main location of pain, the Anterior Impingement test (AIT), Flexion‐Abduction‐External Rotation (FABER) test, and Fitzgerald test had a high sensitivity (range 0.72–0.91). Sensitivity increased when combining these tests (0.97) as either groin as main location of pain and a positive FABER test or a positive AIT and a positive FABER test were the shortest most sensitive combinations. The results of this study point out that in clinical practice absence of groin as main location of pain combined with a negative FABER test or the combination of a negative AIT and a negative FABER test are suggested to rule out the diagnosis of symptomatic FAI and/or labral pathology.
ISSN:0905-7188
1600-0838
DOI:10.1111/sms.12651