title: Imaging and clinical tests for the diagnosis of long-standing groin pain in athletes. A systematic review.
abstract: OBJECTIVE
  To examine the validity of clinical tests available for the diagnosis of longstanding groin pain in athletes.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  A published search strategy of MeSH terms in MEDLINE, CINAHL, EMBASE, and SportDiscuss.
  
  
  METHODS
  diagnostic studies relating to athletic groin pain, professional or semi-professional athletes, symptoms lasting for more than six weeks, and not limited by age or gender. A priori exclusion criteria were utilised.
  
  
  METHODS
  QUADAS tool, sensitivity and specificity, likelihood ratios and predictive values of the reported tests and investigations.
  
  
  RESULTS
  577 Journal articles were identified. Five studies met all requirements. Sensitivity and specificity of clinical tests ranged between 30 and 100% and 88 and 95% respectively with negative likelihood ratio of 0.15-0.78 and positive likelihood ratios of 1.0-11.0. Sensitivity and specificity of investigations (MRI, herniography, and dynamic ultrasound) ranged between 68% and 100% as well as 33% and 100% respectively with negative likelihood ratios between 0 and 0.32 and positive likelihood ratios between 1.5 and 8.1.
  
  
  CONCLUSIONS
  There is a lack of validated diagnostic clinical tests available for clinicians and a lack of symptomology being evaluated. It is recommended that a reference standard should be applied and data should be reported in sufficient detail to calculate diagnostic statistics that is useful to the clinician.
authors: Department of Physiotherapy, School of Health Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Department of Physical Therapies, Australian Institute of Sport, Leverrier Cr, Bruce, ACT 2617, Australia. Electronic address: michaelkdrew@gmail.com.
authors: Michael K
authors: MK
authors: Drew
authors: Department of Physiotherapy, School of Health Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Electronic address: peter.osmotherly@newcastle.edu.au.
authors: Peter G
authors: PG
authors: Osmotherly
authors: Department of Physiotherapy, School of Health Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Electronic address: pauline.chiarelli@newcastle.edu.au.
authors: Pauline E
authors: PE
authors: Chiarelli
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis*; D003952:Diagnostic Imaging / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D006119:Groin / Q000293:injuries*; D006801:Humans; D010147:Pain Measurement / Q000379:methods*; D015203:Reproducibility of Results
keywords: Athletic injury; Diagnosis; Groin; Systematic review