Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis.

Journal Article (Journal Article;Review;Systematic Review)

BACKGROUND: Hip Physical Examination (HPE) tests have long been used to diagnose a myriad of intra-and extra-articular pathologies of the hip joint. Useful clinical utility is necessary to support diagnostic imaging and subsequent surgical decision making. OBJECTIVE: Summarise and evaluate the current research and utility on the diagnostic accuracy of HPE tests for the hip joint germane to sports related injuries and pathology. METHODS: A computer-assisted literature search of MEDLINE, CINHAL and EMBASE databases (January 1966 to January 2012) using keywords related to diagnostic accuracy of the hip joint. This systematic review with meta-analysis utilised the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the search and reporting phases of the study. Der-Simonian and Laird random effects models were used to summarise sensitivities (SN), specificities (SP), likelihood ratios and diagnostic OR. RESULTS: The employed search strategy revealed 25 potential articles, with 10 demonstrating high quality. Fourteen articles qualified for meta-analysis. The meta-analysis demonstrated that most tests possess weak diagnostic properties with the exception of the patellar-pubic percussion test, which had excellent pooled SN 95 (95% CI 92 to 97%) and good specificity 86 (95% CI 78 to 92%). CONCLUSION: Several studies have investigated pathology in the hip. Few of the current studies are of substantial quality to dictate clinical decision-making. Currently, only the patellar-pubic percussion test is supported by the data as a stand-alone HPE test. Further studies involving high quality designs are needed to fully assess the value of HPE tests for patients with intra- and extra-articular hip dysfunction.

Full Text

Duke Authors

Cited Authors

  • Reiman, MP; Goode, AP; Hegedus, EJ; Cook, CE; Wright, AA

Published Date

  • September 2013

Published In

Volume / Issue

  • 47 / 14

Start / End Page

  • 893 - 902

PubMed ID

  • 22773321

Electronic International Standard Serial Number (EISSN)

  • 1473-0480

Digital Object Identifier (DOI)

  • 10.1136/bjsports-2012-091035


  • eng

Conference Location

  • England