How Useful Is the Flexion-Adduction-Internal Rotation Test for Diagnosing Femoroacetabular Impingement: A Systematic Review.
How Useful Is the Flexion-Adduction-Internal Rotation Test for Diagnosing Femoroacetabular Impingement: A Systematic Review.
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屈曲-内收-内旋测试对于诊断股骨髋臼撞击有多大用处：系统评价。
DOI：
10.1097/jsm.0000000000000575
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Ayeni O
中科院分区：
文献类型：
--
作者：
15.Shanmugaraj A;Shell JR;DuongA;Simunovic N;Horner NS;Uchida S;Ayeni O
目的：临床医生使用屈内收内旋（FADIR）试验诊断股髋臼撞击（FAI）。然而，该测试的诊断效用尚不清楚。本综述的目的是确定FADIR测试在诊断FAI中的效用。数据来源：使用相关关键词检索MEDLINE、EMBASE和PubMed，并进行重复研究筛选。记录FAI患者的患者统计资料、诊断影像和FADIR检测的综合指标（如敏感性、特异性等）。主要结果：纳入8项III级（87.5%）和IV级（12.5%）证据研究。452例患者（622髋），平均年龄27.0±9.0岁。Alpha角（75.1%）和/或中心边缘角（26.8%）用于诊断FAI髋部。采用x线（78.9%）、磁共振成像（MRI）（16.2%）和计算机断层扫描（CT）（4.8%）确诊FAI。经x线、MRI或CT证实的敏感性分别为0.08 ~ 1,0.33 ~ 1和0.90。经x线和MRI证实特异性分别为0.11和1。结论：尽管FADIR测试在诊断FAI方面的总体效用尚不清楚，但由于其中等的敏感性和特异性，它可能是一种有用的FAI筛查工具，因为它的低风险。临床医生应考虑报告的敏感性和特异性值的可变性以及现有文献的低质量。未来的研究应采用大样本量和一致的影像学测量，以更好地了解这种体格检查方法在诊断FAI中的有用性。证据等级：IV级，III级和IV级研究的系统评价。股髋臼撞击（FAI）是一种以股骨颈和髋臼之间的基台为特征的髋关节疾病。FAI存在三种亚型：凸轮型、钳型和混合型撞击。1,3凸轮畸形的特征是在股骨头颈前上连接处有一个异常的凸起。钳形畸形是由髋臼形状或/和方向异常引起的，混合性撞击是最常见的亚型，是前两种畸形的组合。1,3由于这些畸形，股骨颈和髋臼缘的重复基台会对髋臼唇和软骨造成损伤。1,4,5此外，FAI与早期退行性改变有关，并与年轻成人骨关节炎（OA）的发展有关。1 - 3, 6 - 9
Objective:Clinicians use the flexion, adduction, and internal rotation (FADIR) test in the diagnosis of femoroacetabular impingement (FAI). However, the diagnostic utility of this test remains unclear. The purpose of this review was to determine the utility of the FADIR test in diagnosing FAI.Data Sources:MEDLINE, EMBASE, and PubMed were searched using relevant key terms and study screening was performed in duplicate. Patient demographics, diagnostic imaging, and summary measures (eg sensitivity, specificity, etc.) of the FADIR test in patients with FAI were recorded.Main Results:Eight studies of levels III (87.5%) and IV (12.5%) evidence were included. Four hundred fifty-two patients (622 hips) with a mean age of 27.0±9.0 were examined. Alpha (75.1%) and/or center-edge (26.8%) angles were used to diagnose hips with FAI. X-ray (78.9%), magnetic resonance imaging (MRI)(16.2%), and computed tomography (CT)(4.8%) were used to confirm the diagnosis of FAI. The sensitivity when confirmed by x-ray, MRI, or CT was 0.08 to 1, 0.33 to 1 and 0.90, respectively. The specificity when confirmed by x-ray and MRI was 0.11 and 1, respectively.Conclusions:Although the overall utility of the FADIR test in diagnosing FAI remains unclear given its moderate sensitivity and specificity, it may be a useful screening tool for FAI because of its low risk. Clinicians should consider the variability in sensitivity and specificity values reported and the low quality of literature available. Future studies should use large sample sizes and consistent radiographic measurements to better understand the usefulness of this physical examination maneuver in diagnosing FAI.Level of Evidence:Level IV, Systematic Review of Level III and IV studies.INTRODUCTIONFemoroacetabular impingement (FAI) is a hip disorder characterized by the abutment between the femoral neck and acetabulum. 1, 2 Three subtypes of FAI exist: cam, pincer, and mixed impingement. 1, 3 Cam deformities are characterized by an abnormal prominence at the anterosuperior femoral head–neck junction. Pincer deformities result from abnormalities in the shape or/and orientation of the acetabulum and mixed impingement, the most common subtype, is a combination of the previous 2 deformities. 1, 3 As a result of these deformities, the repeated abutment of the femoral neck and the acetabular rim can cause damage to the acetabular labrum and cartilage. 1, 4, 5 Moreover, FAI is linked to early degenerative changes and is associated with the development of osteoarthritis (OA) in the young adult. 1–3, 6–9
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髋关节病理学：临床实践中患者病史、体格检查和关节镜检查结果之间的关系
影响因子：
4.1
作者：
M. Tijssen;R. V. Cingel;E. Visser;Per Hölmich;M.W. Nijhuis
通讯作者：
M.W. Nijhuis
DOI：
10.1097/01.blo.0000096804.78689.c2
发表时间：
2003-12-01
影响因子：
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作者：
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通讯作者：
Siebenrock, KA
影响因子：
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作者：
Hananouchi, Takehito;Yasui, Yukihiko;Ohzono, Kenji
通讯作者：
Ohzono, Kenji
影响因子：
2.6
作者：
Khan W;Khan M;Alradwan H;Williams R;Simunovic N;Ayeni OR
通讯作者：
Ayeni OR
影响因子：
4.2
作者：
Barton, Cefin;Salineros, Matias J.;Beaule, Paul E.
通讯作者：
Beaule, Paul E.