Diagnostic accuracy of clinical tests for hip pathology

Despite the lack of investigation into the diagnostic accuracy of hip physical examination (HPE) tests for femoroacetabular impingement (FAI) and acetabular labral tears (ALT), surgery for these two conditions is increasingly been explored. It could be argued that the clinical utility of such measures is imperative to support diagnostic imaging and subsequent surgical treatment. The purpose of the following systematic review was to evaluate the current diagnostic accuracy of numerous clinical tests related to hip FAI/ALT pathology.

Only one out of total 21 studies identified was of high quality. Nevertheless, analyses suggest that both flexion-adduction-internal rotation (FADIR) and flexion-internal rotation (FIR) tests possess screening accuracy only.

These findings highlight the difficulty in diagnosing FAI/ALT clinically due to the lack of substantial quality studies investigating their diagnostic accuracy and clinical utility. It is recommended for future studies to investigate a wider spectrum of hip pathology patients in order to verify the clinical utility of these tests.

> From: Reiman et al., Br J Sports Med (2014) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd. . Click here for the Pubmed summary.