Hip joint pathology: relationship between patient history, physical tests, and arthroscopy findings in clinical practice
Hip joint pathology: relationship between patient history, physical tests, and arthroscopy findings in clinical practice
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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
DOI：
10.1111/sms.12651
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发表时间：
2017
影响因子：
4.1
通讯作者：
M.W. Nijhuis
中科院分区：
文献类型：
--
作者：
M. Tijssen;R. V. Cingel;E. Visser;Per Hölmich;M.W. Nijhuis
这项回顾性队列研究的目的是：(A)描述髋臼撞击(FAI)和髋臼病变的临床表现；(B)描述髋关节镜证实的髋臼撞击和髋臼病变的病史和体格检查的准确性。患者(18-65岁)被纳入，如果他们被转介到物理治疗师那里收集术前数据，然后在关节镜检查中被诊断。收集术前病史和体格检查的结果，并与关节镜检查进行比较。纳入77例活动患者的资料(平均年龄：37岁)。腹股沟是疼痛的主要部位，前撞击试验(AIT)、屈曲-外展-外旋(Faber)试验和Fitzgerald试验具有较高的敏感性(0.72~0.91)。当腹股沟作为疼痛的主要部位和Faber试验阳性或AIT阳性和Faber试验阳性是最短、最敏感的组合时，敏感性增加(0.97)。本研究结果指出，在临床实践中，腹股沟不作为疼痛的主要部位，结合Faber试验阴性，或联合AIT和Faber试验阴性，可排除症状性FAI和/或唇部病理的诊断。
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.