title: Hip joint pathology: relationship between patient history, physical tests, and arthroscopy findings in clinical practice.
abstract: 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.
authors.affiliation: Sports Medical Centre Papendal, Arnhem, Radboud university medical centre, Scientific Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Tijssen
authors.affiliation: Sports Medical Centre Papendal, Arnhem, HAN University of Applied Sciences, Research Group Musculoskeletal Rehabilitation, Nijmegen, the Netherlands.
authors.forename: R E H
authors.initials: RE
authors.lastname: van Cingel
authors.affiliation: Department Orthopaedic Surgery, Rijnstate Hospital Arnhem, Arnhem, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: de Visser
authors.affiliation: Sports Orthopaedic Research Centre - Copenhagen, Arthroscopic Centre, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Hölmich
authors.affiliation: Radboud university medical centre, Scientific Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.
authors.forename: M W G
authors.initials: MW
authors.lastname: Nijhuis-van der Sanden
mesh_terms: D000328:Adult; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D057925:Femoracetabular Impingement / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006621:Hip Joint / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Hip; clinical assessment; diagnostic accuracy; examination