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Tabel 1. Diagnosis of femoroacetabular impingement and labral tear: effectiveness of clinical tests and grading the quality of evidence. Diagnostic effectiveness Diagnosis / Clinical test / Studies & Participants Setting Reference test Likelihood ratio, [95% CI] High Moderate Low Very low
Diagnosis of femoroacetabular impingement / acetabular labral tear
Flexion ADduction Internal Rotation (FADIR) test
Meta-analysis of 188 participants [1]. Secondary care (Hospital) MRA
LR+ = 1.02 [0.96; 1.08]
LR- = 0.45 [0.19; 1.09]
Meta-analysis of 319 participants [1]. Secondary care (Hospital) Surgery
LR+ = 1.04 [0.97; 1.12]
LR- = 0.14 [0.02; 0.93]
Single study with 49 participants with hip pain and being surgical candidates [2].
Single orthopaedic surgeon’s clinic (tertiary referral)
Intra-articular injection
LR+ = 0.86 [0.67; 1.1]
LR- = 2.33 [0.52; 10.4]
Flexion ABduction External Rotation (FABER) test
Single study with 50 participants with symptoms, findings and radiographs suggesting intra-articular hip pain [3].
Multispeciality musculoskeletal clinic at a university medical center
Intra-articular injection
LR+ = 1.10 [0.76; 1.59]
LR- = 0.70 [0.20; 2.39]
Radiographs
LR+ = 0.75 [0.36; 1.56]
LR- = 2.00 [0.59; 6.79]
Single study with 49 participants with hip pain and being surgical candidates [2].
Single orthopaedic surgeon’s clinic (tertiary referral)
Intra-articular injection
LR+ = 0.73 [0.5; 1.1]
LR- = 2.20 [0.8; 6.0]
Single study with 79 participants with at least one imaging finding correlated with intra-articular hip pathology [4].
Single surgeon at ortho. dep. at a hospital Surgery
LR+ = 0.81 [0.72; 0.9]
LR- = N/A
Internal-Rotation test with overpressure
Single study with 50 participants with symptoms, findings and radiographs suggesting intra-articular hip pain [3].
Multispeciality musculoskeletal clinic at a university medical center
Intra-articular blockade
LR+ = 1.10 [0.83; 1.46]
LR- = 0.50 [0.09; 2.69]
MRI/MRA
LR+ = 1.18 [0.83; 1.44]
LR- = 0.00 [0.03; 0.59]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
Resisted straight leg raise
Single study with 50 participants with symptoms, findings and radiographs suggesting intra-articular hip pain [3].
Multispeciality musculoskeletal clinic at a university medical center
Intra-articular blockade
LR+ = 0.87 [0.54; 1.40]
LR- = 1.28 [0.50; 3.30]
MRI/MRA
LR+ = 0.93 [0.44; 1.97]
LR- = 1.13 [0.36; 3.53]
Single study with 79 participants with at least one imaging finding correlated with intra-articular hip pathology [4].
Single surgeon at ortho. dep. at a hospital Surgery
LR+ = 0.21 [0.14; 0.33]
LR- = N/A
Scour test
Single study with 50 participants with symptoms, findings and radiographs suggesting intra-articular hip pain [3].
Multispeciality musculoskeletal clinic at a university medical center
Intra-articular blockade
LR+ = 0.70 [0.43; 1.15]
LR- = 1.72 [0.65; 4.52]
MRI / MRA
LR+ = 1.33 [0.81; 2.2]
LR- = 0.50 [0.08; 2.99]
Trochanteric tenderness
Single study with 49 participants with hip pain and being surgical candidates [2].
Single orthopaedic surgeon’s clinic (tertiary referral)
Intra-articular injection
LR+ = 1.10 [0.36; 3.6]
LR- = 0.93 [0.49; 1.8]
Anterior impingement test
Single study with 79 participants with at least one imaging finding correlated with intra-articular hip pathology [4].
Single surgeon at ortho. dep. at a hospital Surgery
LR+ = 0.91 [0.85; 0.98]
LR- = N/A
“Catching”
Single study with 49 participants with hip pain and being surgical candidates [2].
Single orthopaedic surgeon’s clinic (tertiary referral)
Intra-articular injection
LR+ = 1.39 [0.81; 2.4]
LR- = 0.68 [0.36; 1.3]
“Pinching pain when sitting”
Single study with 49 participants with hip pain and being surgical candidates [2].
Single orthopaedic surgeon’s clinic (tertiary referral)
Intra-articular injection
LR+ = 1.10 [0.58; 1.9]
LR- = 0.95 [0.25; 1.5]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
Tabel 1. Diagnosis of femoroacetabular impingement: effectiveness of clinical tests and grading the quality of evidence. Diagnostic effectiveness Clinical test / Diagnosis / Studies & Participants
Setting Reference test Likelihood ratio, [95% CI] High Moderate Low Very low
Diagnosis of femoroacetabular impingement
Flexion ADduction Internal Rotation (FADIR) test
Single study with 49 participants with clinical signs and symptoms of hip impingement [5].
Orthopaedic dep. at a single hospital
MRI
LR+ = 1.00 [N/A]
LR- = 0.35 [N/A]
Single study with 69 participants with hip pain [6].
Single surgeon at orthopaedic clinic at a hospital
MRI
LR+ = 3.30 [0.48; 23]
LR- = 0.53 [0.33; 0.86]
Single study with 35 youth participants diagnosed with FAI [7].
Single surgeon at children’s hospital Radiographs
LR+ = 1.20 [0.95; 1.52]
LR- = 0.09 [0.00; 3.41]
Single study with 199 participants with unilateral groin or hip pain [8].
Single surgeons’ clinic at a hospital Radiographs
LR+ = 1.08 [0.99; 1.17]
LR- = 0.36 [0.12; 1.08]
Single study with 63 participants referred for non-arthritic hip and groin pain [9].
Single surgeon and physio at orthopaedic dep. at single university hospital
Radiographs + intra-articular injection
LR+ = 1.05 [0.81; 1.35]
LR- = 0.83 [0.32; 2.19]
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.34 [1.04; 1.74]
LR- = 0.28 [0.10; 0.74]
Single study with 94 participants with FAI receiving open surgical dislocation [11]
Orthopaedic dep. at university Surgery
LR+ = 1.0 [N/A]
LR- = 0.18 [N/A]
Single study with 41 participants with clinical diagnosis of FAI [12]
Orthopaedic dep. at hospital
MRA
LR+ = 1.1 [0.86; 1.41]
LR- = 0.22 [0.01; 3.87]
Single study with 68 participants undergoing joint-preserving surgery [13]
Orthopaedic dep. at hospital
MRA
LR+ = 1.0 [N/A]
LR- = 0.59 [N/A]
Flexion Internal Rotation test
Single study with 241 participants with mechanical hip pathology and pain for more 4 months [14].
Four surgical centers Radiographs
LR+ = 1.25 [1.01; 1.54]
LR- = 0.68 [0.49; 0.96]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
Single study with 63 participants referred for non-arthritic hip and groin pain [9].
Single surgeon and physio at orthopaedic dep. at single university hospital
Radiographs + intra-articular injection
LR+ = 1.51 [0.87; 2.63]
LR- = 0.70 [0.44; 1.12]
Flexion ABduction External Rotation (FABER) test
Single study with 603 participants with symptomatic unilateral FAI, who underwent hip arthroscopy [15]. – FABER distance
Single physician at a single medical center Radiographs
LR+ = 1.36 [1.23; 1.5]
LR- = 0.41 [0.28; 0.59]
Single study with 63 participants referred for non-arthritic hip and groin pain [9].
Single surgeon and physio at orthopaedic dep. at single university hospital
Radiographs + intra-articular injection
LR+ = 0.87 [0.57; 1.33]
LR- = 1.21 [0.68; 2.17]
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.20 [0.89; 1.61]
LR- = 0.62 [0.31; 1.26]
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
LR+ = 1.01 [0.83; 1.24]
LR- = 0.93 [0.34; 2.53]
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
LR+ = 0.79 [0.55; 1.14]
LR- = 1.40 [0.79; 2.47]
Squat
Single study with 76 participants with hip pain [16].
Blinded researcher at outpatient orthopaedic clinic at a university
MRI/MRA
LR+ = 1.28 [0.93; 1.75]
LR- = 0.61 [0.30; 1.21]
Trochanteric tenderness
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 0.78 [0.44; 1.38]
LR- = 1.17 [0.80; 1.69]
Anterior impingement test
Single study with 63 participants referred for non-arthritic hip and groin pain [9].
Single surgeon and physio at orthopaedic dep. at single university hospital
Radiographs + intra-articular injection
LR+ = 1.08 [0.82; 1.41]
LR- = 0.77 [0.31; 1.93]
_DEXRIT or DIRIT_*
Single study with 63 participants referred for non-arthritic hip and groin pain [9].
Single surgeon and physio at orthopaedic dep. at single university hospital
Radiographs + intra-articular injection
LR+ = 1.11 [0.72; 1.71]
LR- = 0.87 [0.49; 1.54]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
Resisted External Derotation
Single study with 75 participants with hip- related pain or mechanical symptoms [10] Outpatient clinic FAIS according to Warwick
LR+ = 0.72 [0.41; 1.28]
LR- = 1.20 [0.85; 1.69]
Thomas test
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.19 [0.44; 3.19]
LR- = 0.96 [0.77; 1.20]
Log Roll
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 0.40 [0.10; 1.68]
LR- = 1.09 [0.94; 1.27]
“Clicking or Catching”
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.24 [0.64; 2.4]
LR- = 0.88 [0.62; 1.27]
“Clicking”
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.24 [0.64; 2.4]
LR- = 0.88 [0.62; 1.27]
“Catching”
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.24 [0.64; 2.4]
LR- = 0.88 [0.62; 1.27]
“Pain when sitting”
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 1.06 [0.66; 1.68]
LR- = 0.95 [0.60; 1.49]
“Anterior/Groin/Hip Pain”
Single study with 75 participants with hip- related pain or mechanical symptoms [10]
Single specialist at outpatient clinic
FAIS according to Warwick
LR+ = 0.81 [0.36; 1.82]
LR- = 1.08 [0.79; 1.49]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
Tabel 1. Diagnosis of acetabular labral tear: effectiveness of clinical tests and grading the quality of evidence.
Diagnostic effectiveness Clinical test / Diagnosis / Studies & Participants Setting Reference test Likelihood ratio, [95% CI] High Moderate Low Very low
Diagnosis of acetabular labral tear
Flexion ADduction Internal Rotation (FADIR) test
Single study with 35 youth participants diagnosed with FAI [7].
Single surgeon at children’s hospital
MRI
LR+ = 1.00 [N/A]
LR- = 0.76 [N/A]
Single study with 30 participants with painful non-dysplastic hips and positive impingement sign [17]
Orthopaedic dep. at university
MRA
LR+ = 1.3 [0.59; 2.86]
LR- = 0.06 [0.00; 3.03]
Single study with 101 participants with clinical signs and symptoms of ALT [18]
Orthopaedic dep. at single hospital
MRA
LR+ = 1.0 [N/A]
LR- = 0.3 [N/A]
Single study with 97 participants who underwent surgical treatment for FAI [19] Single hospital Surgery
LR+ = 1.1 [0.87; 1.38]
LR- = 0.09 [0.00; 1.85]
Single study with 23 participants with ARS [20]
Orthopaedic dep. at university hospital Surgery
LR+ = 1.1 [0.78; 1.55]
LR- = 0.23 [0.01; 9.98]
Single study with 18 participants with hip dysplasia undergoing arthroscopy and PAO [21]
Orthopaedic dep. at a public hospital
MRA
LR+ = 2.3 [0.08; 68]
LR- = 0.56 [0.16; 1.99]
Single study with 21 participants with acetabular labral tears undergoing hip arthroscopy [22]
Orthopaedic dep. at a hospital Radiographs
LR+ = 1.0 [N/A]
LR- = 0.7 [N/A]
Flexion Internal Rotation test
Meta-analysis of 27 participants [1]. Secondary care (hospital) Surgery
LR+ = 1.28 [0.72; 2.27]
LR- = 0.15 [0.01; 1.99]
Single study with 30 participants with suspected labral tears [23].
Orthopaedic dep. at a hospital
MRA
LR+ = 1.10 [0.82; 1.48]
LR- = 0.23 [0.01; 6.13]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
“Anterior groin pain”
Single study with 59 participants with hip pain for 6 months [25]. Hospital Surgery
LR+ = 1.04 [N/A]
LR- = 0.00 [N/A]
“Giving way”
Single study with 59 participants with hip pain for 6 months [25]. Hospital Surgery
LR+ = 3.35 [N/A]
LR- = 0.52 [N/A]
Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
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Supplemental material placed on this supplemental material which has been supplied by the author(s)^ Br J Sports Med
