Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing even though there is a lack investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is needed to support diagnostic imaging and subsequent surgical decision-making. Summarise/evaluate the current diagnostic accuracy of various clinical tests germane to hip FAI/ALT pathology. The employed search strategy revealed 21 potential articles, with one exhibiting high quality. Nine articles qualified for meta-analysis. The meta-analysis showed that flexion-adduction-internal rotation (pooled SN ranging from 0.94 (95% CI 0.90 to 0.97) to 0.99 (95% CI 0.98 to 1.00); DOR 5.71 (95% CI 0.84 to 38.86) to 7.82 (95% CI 1.06 to 57.84)) and flexion-internal rotation (pooled SN 0.96 (95% CI 0.81 to 0.99); DOR 8.36 (95% CI 0.41 to 171.3) tests possess only screening accuracy.

Few hip physical examination tests for diagnosing FAI/ALT have been examined in enough studies of substantial quality to direct clinical decision-making. Further high-quality studies across a wider spectrum of hip pathology patients are suggested to discern the confirmed clinical utility of these tests.

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