Note: To access the video accompanying this report, visit the June issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic Review With Video IllustrationDiagnostics of Femoroacetabular Impingement and Labral Pathology of the Hip: A Systematic Review of the Accuracy and Validity of Physical Tests
Section snippets
Methods
The objective of this study was to identify (1) which physical diagnostic tests are used to assess intra-articular hip pathology, especially FAI and labral pathology; (2) the diagnostic accuracy and validity of these tests; and (3) the quality of the diagnostic accuracy studies describing these tests.
Results
The search identified a total of 307 studies. Based on the title and abstract, 245 studies were excluded. There were 16 doubles, and 25 studies were excluded based on full-text assessment, which left a total of 21 studies to be included (Fig 1). Of these studies, 7 described tests for diagnosing FAI and/or labral pathology and 14 focused on diagnostic accuracy. There were minor disagreements between reviewers regarding inclusion of studies, but consensus was reached in all cases.
Discussion
This review identified 21 studies describing 18 physical diagnostic tests for the assessment of FAI and/or labral pathology of the hip joint. Of the studies, 7 gave a description of these tests and 14 were diagnostic accuracy studies. Many physical tests were the objective of previous studies, but results show that there was a lack of diagnostic accuracy parameters or these parameters had poor values. This was supported by our finding that based on the QUADAS score, only 3 of 14 diagnostic
Conclusions
There exists a wide range of physical diagnostic tests for FAI and/or labral pathology and little information on the diagnostic accuracy and validity. The methodologic quality of the diagnostic accuracy studies is moderate to poor. Uniformity in test executions is warranted, and these should be thoroughly investigated for diagnostic accuracy and validity. For now, no (combination of) physical diagnostic tests are available that can reliably confirm or discard the diagnoses of FAI and/or labral
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The authors report that they have no conflicts of interest in the authorship and publication of this article.