Additional file 2. Diagnostic performances of physical test-hip pathology combinations included in review
Article Title: A systematic review of the diagnostic performance of orthopedic physical examination tests of the hip.
Journal: BMC Musculoskeletal Disorders
Authors: Labib A. Rahman1; Sam Adie1,2,3 ; Justine M. Naylor 1,2,3; Rajat Mittal1,2,3; Sarah So1; Ian A. Harris1,2,3
1
South West Sydney Clinical School, University of New South Wales, 2Orthopaedic Department, Liverpool Hospital, 3Whitlam Orthopaedic Research Centre
Study
Test
Pathology
Reference
Standard
Adams et al.
Patellar-Pubic
Traumatic
1997 [1]
Percussion
Fracture
Anwar et al.
Trendelenburg
Greater
Radiography
Radiography
Sensitivity
Specificity
(95%CI)
(95%CI)
TP/
TN/
(TP+FN)
(TN+FP)
0.79
0.95
0.65-0.83
0.84-0.99
15/19
21/22
0.80
0.71
PPV
0.94
NPV
0.84
+LR
-LR
(95%CI)
(95%CI)
17.37
0.22
3.97-
0.17-0.42
98.43
0.53
0.89
2.74
0.28
1993 [2]
Sign
Trochanter
(implied)
Nonunion
0.54-0.94
0.60-0.77
8/10
17/24
0.91
0.82
083 – 0.96
0.72 – 0.88
51/56
36/44
0.73
0.77
0.51-0.87
0.59-0.89
8/11
10/13
1.36-4.02
0.08-0.76
5.01
0.11
2.92 –
0.04 –
8.20
0.28
3.15
0.35
1.24-7.84
0.15-0.83
following
Cemented THA
in patients with
neglected
Congenital
Dislocation of
the Hip (CDH)
Bache et al.
Bartford test
Fractured neck
Radiography
of femur
1984 [3]
Bird et al.
Trendelenburg
Partial or
2001 [4]
Sign
Complete
MRI
Gluteus Medius
Tendon Tear
0.86
0.73
0.88
0.77
Bird et al.
Pain on Resisted
Partial or
2001 [4]
Abduction
Complete
MRI
0.73
0.46
0.52-0.89
0.29-0.60
8/11
6/13
0.55
0.69
0.34-0.72
0.51-0.84
6/11
9/13
0.86
0.54
0.79-0.91
0.48-0.58
72/84
57/106
0.53
0.67
1.35
0.59
0.73-2.21
0.19-1.68
1.77
0.66
0.69-4.54
0.33-1.29
1.85
0.27
1.52-2.17
0.15-0.44
Gluteus Medius
Tendon Tear
Bird et al.
Pain on Resisted
Partial or
2001 [4]
Adduction
Complete
MRI
0.60
0.64
Gluteus Medius
Tendon Tear
Birrell et al.
Restriction in
Mild-Moderate
2001 [5]
One Plane from
Symptomatic
Either: (1)
Osteoarthritis
Radiography
Passive Flexion
ROM < 94o, (2)
External
Rotation ROM <
23o or (3)
Internal Rotation
0.60
0.83
ROM < 23o.
Measured in
seated position
with fluid
plurimeter.
Birrell et al.
Restriction in
Mild-Moderate
2001 [5]
Two Planes from
Symptomatic
Either: (1)
Osteoarthritis
Radiography
0.56
0.77
0.48-0.63
0.71-0.83
47/84
82/106
Passive Flexion
ROM < 94o, (2)
External
Rotation ROM <
23o or (3)
Internal Rotation
ROM < 23o.
Measured in
seated position
0.66
0.69
2.47
0.57
1.69-3.64
0.45-0.72
with fluid
plurimeter.
Birrell et al.
Restriction in
Mild-Moderate
2001 [5]
Three Planes: (1)
Symptomatic
Passive Flexion
Osteoarthritis
Radiography
0.32
0.93
0.26-0.36
0.89-0.97
0.79
0.63
ROM < 94o, (2)
4.87
0.73
2.32-
0.66-0.83
10.57
External
27/84
99/106
0.57
0.85
Rotation ROM <
23o and (3)
Internal Rotation
ROM < 23o.
Measured in
seated position
with fluid
plurimeter.
Garcia et al.
Trendelenburg
Abductor
Sonography
0.50
0.88
3.86
0.50
2010 [6]
Sign
Avulsion
Following
0.28-0.81
0.78-0.91
4/7
23/27
0.51
0.89
0.46 – 0.52
0.66 – 0.98
45/89
16/18
0.58
0.66
0.47–0.68
0.59–0.72
44/76
150/228
0.56
0.78
0.45–0.67
0.72–0.83
42/75
178/228
1.25 –
0.21-0.93
9.34
Primary THA
Hananouchi et
Anterior
Anterosuperior
al. 2012 [7]
impingement test
labral lesions
Holla et al.
Assisted active
Early
2012 [8]
hip flexion <
symptomatic hip
114o as
osteoarthritis
MRI
Radiography
0.96
0.36
0.27
0.82
4.55
0.56
1.35 –
0.49 –
26.64
0.82
1.69
0.64
1.30–2.20
0.48–0.85
2.55
0.56
1.86–3.51
0.43–0.73
measured with
goniometer
Holla et al.
Assisted active
Early
2012 [8]
hip internal
symptomatic hip
rotation < 24o as
osteoarthritis
measured with
goniometer
Radiography
0.46
0.84
Hossain et al.
Restricted
Radiologically
2007 [9]
Straight Leg
Occult Hip
Raise
Fracture
Hossain et al.
Log Roll Test
Radiologically
2007 [9]
(Passive
Occult Hip
Rotation)
Fracture
Hossain et al.
Pain on Axial
Radiologically
2007 [9]
Loading
Occult Hip
MRI
MRI
MRI
0.50
0.42
0.37-0.64
0.31-0.54
13/26
13/31
0.62
0.48
0.48-0.75
0.37-0.59
16/26
15/31
0.73
0.58
0.59-0.84
0.46-0.68
19/26
18/31
0.42
0.50
0.59
0.50
0.60
0.72
0.86
1.19
0.53-1.38
0.68-2.04
1.19
0.79
0.75-1.83
0.43-1.43
1.74
0.46
1.10-2.61
0.23-0.88
34.29
0.24
10.97 –
0.17-0.41
Fracture
Khadilkar et
Hip Abduction
Sarcoglycan-
Immunocyto-
0.76
0.98
al. 2001 [10]a
Signb
opathies in
chemistry
0.61-0.83
0.94-0.99
16/21
88/90
patients with
known muscular
dystrophy
0.89
0.95
122.30
Narvani et al.
Discomfort on
Acetabular
2003 [11]
Internal
Labral Tears
MRA
0.75
0.43
0.34-0.95
0.31-0.49
3/4
6/14
0.47
0.81
0.33-0.59
0.75-0.88
14/30
48/59
0.19
0.93
0.10-0.29
0.89-0.96
5/26
64/69
0.00
1.00
0.27
0.86
1.31
0.58
0.50-1.86
0.10-2.11
2.50
0.66
1.31-4.70
0.47-0.89
2.65
0.90
0.87-8.04
0.74-1.02
7.23
0.98
RotationFlexion-Axial
Compression
Manoeuvre
Olsson et al.
Trendelenburg
Cemented
1981 [12]
Sign
Femoral Stem
Radiography
0.56
0.75
Loosening PostTHA
Olsson et al.
Painful or
Cemented
1981 [12]
Impossible
Femoral Stem
Active Straight
Loosening Post-
Röder et al.
Leg-Raise
THA
Pain on Axial
Uncemented
Radiography
Radiography
0.50
0.00
0.71
0.99
2003 [13]
Compression
Acetabular Cup
Loosening Post-
0.00-0.13
1.00-1.00
0/17
1685/ 1691
0.13
0.99
0.05-0.23
0.98-0.99
4/32
680/690
0.08
0.99
0.03-0.17
0.99-1.00
4/49
2365/ 2381
0.19
0.97
0.08-0.39
0.97-0.97
4/21
1639/ 1687
0.21
0.96
0.71 –
0.84 –
67.39
1.00
8.63
0.89
2.93-
0.78-0.97
THA
Röder et al.
Pain on Axial
Uncemented
2003 [13]
Compression
Acetabular Cup
Radiography
0.29
0.96
Loosening Post-
24.30
THA
Pooled Data:
Pain on Axial
Uncemented
Röder et al.
Compression
Acetabular Cup
Radiography
0.20
0.98
Loosening Post-
2003 [13]
12.15
0.93
4.33 –
0.84 –
32.83
0.97
6.69
0.83
2.60-
0.63-0.95
THA
Röder et al.
Pain on Internal
Uncemented
2003 [13]
Rotation
Acetabular Cup
Radiography
0.08
0.99
Loosening Post-
14.91
THA
Röder et al.
Pain on Internal
Uncemented
Radiography
0.19
0.96
4.72
0.83
2003 [13]
Rotation
Acetabular Cup
Loosening Post-
0.11-0.35
0.95-0.96
7/34
658/688
0.20
0.97
0.12 – 0.31
0.97 – 0.97
11/ 55
2297/ 2375
0.06
0.99
0.01-0.22
0.99-0.99
1/18
1677/ 1690
0.06
0.99
0.02-0.15
0.99-1.00
2/31
685/ 691
0.06
0.99
2.21-9.40
0.68-0.94
6.09
0.83
3.39 –
0.71 –
10.37
0.91
7.22
0.95
1.22-
0.78-1.00
THA
Pooled Data:
Pain on Internal
Uncemented
Röder et al.
Rotation
Acetabular Cup
Radiography
0.12
0.07
Loosening Post-
2003 [13]
THA
Röder et al.
Pain on External
Uncemented
2003 [13]
Rotation
Acetabular Cup
Radiography
0.07
0.99
Loosening Post-
37.83
THA
Röder et al.
Pain on External
Uncemented
2003 [13]
Rotation
Acetabular Cup
Radiography
0.25
0.96
Loosening Post-
7.43
0.94
1.74-
0.86-0.99
30.74
THA
Pooled Data:
Pain on External
Uncemented
Radiography
0.14
0.98
7.67
0.95
Röder et al.
Rotation
Acetabular Cup
Loosening Post-
2003 [13]
0.02 – 0.14
0.99 – 0.99
3/ 49
2362/ 2381
0.00
0.99
0.00-0.26
0.99-1.00
0/8
746/ 752
0.02
1.00
0.00-0.04
0.99-1.00
1/61
441/443
0.01
0.99
0.00 – 0.06
0.99 – 1.00
1/ 69
1187/ 1195
1.00
0.95
2.45 –
0.86 –
22.97
0.99
6.44
0.95
0.64 –
0.63 –
54.06
77.34
3.63
0.99
0.48-
0.96-1.00
THA
Röder et al.
Pain on Axial
Cemented
2003 [13]
Compression
Acetabular Cup
Radiography
0.00
0.99
Loosening PostTHA
Röder et al.
Pain on Axial
Cemented
2003 [13]
Compression
Acetabular Cup
Radiography
0.33
0.88
Loosening Post-
27.51
THA
Pooled Data:
Pain on Axial
Cemented
Röder et al.
Compression
Acetabular Cup
Radiography
0.11
0.95
Loosening Post-
2003 [13]
2.17
0.99
0.35 –
0.95 –
13.00
1.01
16.87
0.18
THA
Röder et al.
Pain on Internal
Cemented
Radiography
0.05
1.00
2003 [13]
Rotation
Acetabular Cup
Loosening Post-
0.35-1.00
0.95-0.95
2/2
721/ 758
0.21
0.93
0.13-0.30
0.92-0.94
12/58
413/ 446
0.23
0.94
0.15 – 0.34
0.94 – 0.95
14/ 60
1134/ 1204
0.02
1.00
0.00-0.03
1.00-1.00
1/59
444/445
0.00
1.00
6.08 –
0.02 –
20.12
0.72
2.80
0.86
1.52-4.96
0.74-0.95
4.01
0.81
2.37 –
0.70 –
6.48
0.91
7.54
0.99
0.79-
0.97-1.00
THA
Röder et al.
Pain on Internal
Cemented
2003 [13]
Rotation
Acetabular Cup
Radiography
0.27
0.90
Loosening PostTHA
Pooled Data:
Pain on Internal
Cemented
Röder et al.
Rotation
Acetabular Cup
Radiography
0.17
0.96
Loosening Post-
2003 [13]
THA
Röder et al.
Pain on External
Cemented
2003 [13]
Rotation
Acetabular Cup
Radiography
0.50
0.88
Loosening Post-
72.05
THA
Röder et al.
Pain on External
Cemented
Radiography
0.00
0.99
16.73
0.95
2003 [13]
Rotation
Acetabular Cup
Loosening Post-
0.00-0.16
1.00-1.00
0/8
750/ 752
0.02
1.00
0.00 – 0.04
1.00 – 1.00
1/67
1194 /1197
0.08
0.99
0.08-0.02
0.98-1.00
1/12
166/168
0.05
0.99
0.01-0.16
0.99-1.00
1/19
443/ 447
0.07
0.99
1.51 –
0.78 –
172.69
1.00
5.96
0.99
0.86 –
0.96 –
41.13
1.00
7.00
0.93
0.93-
0.81-1.00
THA
Pooled Data:
Pain on External
Cemented
Röder et al.
Rotation
Acetabular Cup
Radiography
0.25
0.95
Loosening Post-
2003 [13]
THA
Röder et al.
Pain on Axial
Uncemented
2003 [13]
Compression
Femoral Stem
Radiography
0.33
0.94
Loosening Post-
51.26
THA
Röder et al.
Pain on Axial
Uncemented
2003 [13]
Compression
Femoral Stem
Radiography
0.20
0.96
Loosening Post-
5.88
0.96
0.89-
0.84-1.00
37.05
THA
Pooled Data:
Pain on Axial
Uncemented
Radiography
0.25
0.96
6.61
0.95
Röder et al.
Compression
Femoral Stem
Loosening Post-
2003 [13]
0.02 – 0.15
0.99 – 1.00
2/ 31
609 /615
0.18
0.96
0.08-0.35
0.95-0.97
4/22
425/ 444
0.33
0.93
0.15-0.57
0.92-0.95
4/12
157/ 168
0.24
0.95
0.13 – 0.38
0.95 – 0.96
8 /34
582 /612
0.00
0.99
1.55 –
0.86 –
27.35
0.99
4.25
0.86
1.57-
0.67-0.97
THA
Röder et al.
Pain on Internal
Uncemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.17
0.96
Loosening Post-
10.35
THA
Röder et al.
Pain on Internal
Uncemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.27
0.95
Loosening Post-
5.09
0.71
1.84-
0.45-0.93
11.80
THA
Pooled Data:
Pain on Internal
Uncemented
Röder et al.
Rotation
Femoral Stem
Radiography
0.21
0.96
Loosening Post-
2003 [13]
4.80
0.80
2.35 –
0.65 –
9.14
0.92
2.60
0.98
THA
Röder et al.
Pain on External
Uncemented
Radiography
0.00
0.93
2003 [13]
Rotation
Femoral Stem
Loosening Post-
0.00-0.11
0.99-1.00
0/12
166/ 168
0.05 ()
0.99 ()
0.01-0.18
0.99-0.99
1/19
441/ 447
0.03
0.99
0.01 – 0.12
0.99 – 0.99
1 /31
607 /615
0.02
0.99
0.00-0.04
0.99-0.99
2/136
898/ 910
0.04
1.00
0.23 –
0.85 –
27.49
1.01
3.92
0.96
0.62-
0.83-1.01
THA
Röder et al.
Pain on External
Uncemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.14
0.96
Loosening Post-
22.91
THA
Pooled Data:
Pain on External
Uncemented
Röder et al.
Rotation
Femoral Stem
Radiography
0.11
0.95
Loosening Post-
2003 [13]
2.48
0.98
0.40 –
0.89 –
14.42
1.01
1.12
1.00
0.28-4.37
0.97-1.01
17.34
0.97
THA
Röder et al.
Pain on Axial
Cemented
2003 [13]
Compression
Femoral Stem
Radiography
0.14
0.87
Loosening PostTHA
Röder et al.
Pain on Axial
Cemented
Radiography
0.43
0.96
2003 [13]
Compression
Femoral Stem
Loosening Post-
0.01-0.06
1.00-1.00
3/83
1915/ 1919
0.02
0.99
0.01 – 0.04
0.99 – 1.00
5 /219
2813/ 2829
0.15
0.95
0.10-0.20
0.94-0.96
20/137
862/ 909
0.17
0.97
0.10-0.26
0.97-0.98
12/72
1876/ 1930
0.15
0.96
4.38-
0.94-0.99
68.47
THA
Pooled Data:
Pain on Axial
Cemented
Röder et al.
Compression
Femoral Stem
Radiography
0.24
0.93
Loosening Post-
2003 [13]
4.04
0.98
1.54 –
0.96 –
10.48
1.00
2.82
0.90
1.72-4.56
0.84-0.96
5.96
0.86
3.31-
0.76-0.93
THA
Röder et al.
Pain on Internal
Cemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.30
0.88
Loosening PostTHA
Röder et al.
Pain on Internal
Cemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.21
0.97
Loosening Post-
10.34
THA
Pooled Data:
Pain on Internal
Cemented
Radiography
0.24
0.94
4.30
0.88
Röder et al.
Rotation
Femoral Stem
Loosening Post-
2003 [13]
0.11 – 0.20
0.96 – 0.97
32/ 209
2738 /2839
0.02
0.99
0.00-0.03
0.99-1.00
2/137
903/ 909
0.06
1.00
0.03-0.09
1.00-1.00
5/85
1913/ 1917
0.03
1.00
0.02 – 0.05
1.00 – 1.00
2.96 –
0.83 –
6.19
0.92
2.21
0.99
0.51-9.48
0.97-1.00
28.19
0.94
8.30-
0.92-0.98
THA
Röder et al.
Pain on External
Cemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.25
0.87
Loosening PostTHA
Röder et al.
Pain on External
Cemented
2003 [13]
Rotation
Femoral Stem
Radiography
0.56
0.96
Loosening Post-
95.94
THA
Pooled Data:
Pain on External
Cemented
Röder et al.
Rotation
Femoral Stem
Radiography
0.41
0.22
Loosening Post-
2003 [13]
8.91
0.97
3.53 –
0.95 –
22.43
0.99
3.07
0.95
THA
Röder et al.
Flexion ROM <
Uncemented
Radiography
0.07
0.98
0.12
0.96
2003 [13]
70o
Acetabular Cup
Loosening
Röder et al.
Flexion ROM <
Uncemented
2003 [13]
70o
Acetabular Cup
Radiography
0.02-0.18
0.98-0.98
2/30
675/ 690
0.00
0.98
0.00-0.10
0.98-0.99
0/33
1641/ 1670
0.06
0.98
0.01-0.21
0.98-0.98
2/32
2316/2360
0.00
0.96
0.00-0.34
0.96-0.96
0/7
712/ 745
0.08
0.94
0.04-0.16
0.94-0.95
5/61
410/ 435
0.7911.05
0.00
0.98
Loosening
Pooled Data:
Flexion ROM <
Uncemented
Röder et al.
70o
Acetabular Cup
Radiography
0.04
0.99
Loosening
2003 [13]
Röder et al.
Flexion ROM <
Cemented
2003 [13]
70o
Acetabular Cup
Radiography
Flexion ROM <
Cemented
2003
70o
Acetabular Cup
Radiography
Loosening
0.83
1.00
0.09 –
0.90 –
7.41
1.02
3.25
0.96
0.55-
0.81-1.01
12.31
0.00
0.99
Loosening
Röder et al.
0.83-1.01
0.17
0.88
1.39
0.98
0.14 –
0.64 –
9.43
1.04
1.43
0.97
0.57-3.41
0.88-1.03
Pooled Data:
Flexion ROM <
Cemented
Röder et al.
70o
Acetabular Cup
Radiography
0.07
0.95
0.03-0.16
0.95-0.96
5/68
1122/1180
0.14
0.97
0.05-0.31
0.96-0.98
3/21
428/ 442
0.15
0.99
0.05-0.22
0.99-1.00
2/13
166/ 167
0.15
0.98
0.06-0.28
0.97-0.98
5/34
594/609
0.03
0.95
0.08
0.95
0.97
0.54-3.65
0.88-1.03
4.51
0.89
1.43-
0.71-0.98
Loosening
2003 [13]
Röder et al.
Flexion ROM <
Uncemented
2003 [13]
70o
Femoral Stem
Radiography
Loosening
Röder et al.
Flexion ROM <
Uncemented
2003 [13]
70o
Femoral Stem
Radiography
0.18
0.96
12.90
0.67
0.94
Loosening
Pooled Data:
Flexion ROM <
Uncemented
Röder et al.
70o
Femoral Stem
Radiography
Flexion ROM <
Cemented
Radiography
25.69
0.85
3.48-
0.78-0.96
193.36
0.25
0.95
Loosening
2003 [13]
Röder et al.
1.50
5.97
0.87
1.95-
0.73-0.97
16.128
0.04
0.96
0.51
1.03
2003 [13]
70o
Femoral Stem
Loosening
Röder et al.
Flexion ROM <
Cemented
2003 [13]
70o
Femoral Stem
Radiography
0.01-0.08
0.95-0.95
2/80
1819/ 1912
0.07
0.96
0.04-0.11
0.96-0.97
9/138
863/ 898
0.05
0.95
0.03-0.09
0.95-0.96
11/218
2682/2810
0.20
0.87
0.14-1.81
0.96-1.05
1.67
0.97
0.83-3.33
0.92-1.01
1.11
1.00
0.57-2.06
0.95-1.02
0.50
1.04
0.03 –
0.94 –
8.57
1.15
Loosening
Pooled Data:
Flexion ROM <
Cemented
Röder et al.
70o
Femoral Stem
Radiography
0.08
0.93
Loosening
2003 [13]
Shin et al.
Active Flexion
Femoral Neck
6-week Follow
0.00
1.00
1996 [14]
ROM < 113o.
Stress Fracture
up Radiography
0.00-0.00
1.00-1.00
Measured using
(radiologically
0/13
6/6
Goniometer.
occult but
suggestive bone
-
0.32
scintigraphy)
Shin et al.
Active Extension
Femoral Neck
6-week Follow
0.69
0.67
1996 [14]
ROM < 28o.
Stress Fracture
up Radiography
0.55-0.80
0.35-0.89
Measured using
(radiologically
9/13
4/6
Goniometer.
occult but
0.82
0.50
2.08
0.46
0.84-7.16
0.23-1.31
0.81
3.50
0.72 –
0.40 –
1.28
37.01
0.31
1.69
0.08-1.29
0.92-3.32
suggestive bone
scintigraphy)
Shin et al.
Active Internal
Femoral Neck
6-week Follow
0.77
0.00
1996 [14]
Rotation ROM <
Stress Fracture
up Radiography
0.77-0.89
0.00-0.26
45o. Measured
(radiologically
10/13
0/6
using
occult but
Goniometer.
suggestive bone
0.63
0.00
scintigraphy)
Shin et al.
Active External
Femoral Neck
6-week Follow
0.15
0.50
1996 [14]
Rotation ROM <
Stress Fracture
up Radiography
0.06-0.28
0.29-0.78
45o. Measured
(radiologically
2/13
3/6
0.40
0.21
using
occult but
Goniometer.
suggestive bone
scintigraphy)
Shin et al.
Active
Femoral Neck
6-week Follow
0.62
0.33
1996 [14]
Abduction ROM
Stress Fracture
up Radiography
0.51-0.76
0.11-0.64
< 48o. Measured
(radiologically
8/13
2/6
using
occult but
Goniometer.
suggestive bone
0.67
0.29
0.92
1.15
0.57-2.10
0.38-4.62
1.50
0.10
1.00 –
0.01 –
1.72
0.98
1.11
0.46
scintigraphy)
Shin et al.
Pain on Log Roll
Femoral Neck
6-week Follow
1.00
0.33
1996 [14]
Test
Stress Fracture
up Radiography
0.90-1.00
0.12-0.33
13/13
2/6
0.92
0.17
0.76
1.00
(radiologically
occult but
suggestive bone
scintigraphy)
Shin et al.
Pain on Active
Femoral Neck
6-week Follow
0.71
0.50
1996 [14]
Straight Leg
Stress Fracture
Raise
(radiologically
up Radiography
0.86-0.99
0.03-0.30
12/13
1/6
0.43
0.88
0.28-0.56
0.82-0.94
9/21
45/51
0.52
0.80
0.36-0.67
0.74-0.87
11/21
41/51
0.33
0.94
0.20-0.42
0.89-0.98
7/21
48/51
0.89-1.41
0.05-4.26
3.64
0.65
1.52-8.68
0.47-0.89
2.67
0.59
1.34-5.02
0.38-0.88
5.67
0.71
1.76-
0.59-0.90
occult but
suggestive bone
scintigraphy)
Sutlive et al.
Lateral Pain on
Symptomatic
2008 [15]
Active Hip
Osteoarthritis
Radiography
0.60
0.79
Flexion. Patient
Supine.
Sutlive et al.
Pain on Active
Symptomatic
2008 [15]
Hip Extension.
Osteoarthritis
Radiography
0.52
0.80
Patient Prone.
Sutlive et al.
Pain on
Symptomatic
2008 [15]
Abduction
Osteoarthritis
Radiography
and/or
Adduction.
0.70
0.77
19.05
Patient Supine.
Sutlive et al.
Passive Internal
Symptomatic
2008 [15]
Rotation </= 25o.
Osteoarthritis
Radiography
0.76
0.61
0.58-0.89
0.54-0.66
16/21
31/51
0.24
0.96
0.13-0.31
0.91-0.99
5/21
49/51
0.62
0.75
0.44-0.77
0.67-0.81
13/21
38/51
0.57
0.71
0.40-0.73
0.63-0.77
12/21
36/51
0.44
0.86
1.94
0.39
1.25-2.60
0.17-0.78
6.07
0.79
1.46-
0.70-0.96
Measured with
inclinometer.
Patient Prone.
Sutlive et al.
Squat Test
Radiography
Osteoarthritis
2008 [15]
Sutlive et al.
Symptomatic
Scour Test
Symptomatic
Radiography
Osteoarthritis
2008 [15]
Sutlive et al.
FABER/
Symptomatic
2008 [15]
Patrick’s Test <
Osteoarthritis
Radiography
60o
0.71
0.75
26.32
0.50
0.44
0.83
0.80
2.43
0.51
1.36-3.97
0.29-0.83
1.94
0.61
1.08-3.18
0.35-0.95
Sutlive et al.
5-Part Clinical
Symptomatic
2008 [15]
Prediction Rule c
Osteoarthritis
Radiography
0.95
0.18
0.82-0.99
0.12-0.19
20/21
9/51
0.81
0.61
0.63-0.92
0.54-0.65
17/21
31/51
0.71
0.86
0.55-0.84
0.79-0.91
15/21
44/51
0.48
0.98
0.34-0.52
0.93-1.00
10/21
50/51
0.32
0.90
1.16
0.27
0.94-1.23
0.05-1.46
2.06
0.31
1.37-2.65
0.12-0.68
5.20
0.33
2.66-9.57
0.18-0.57
24.29
0.53
4.64-
0.49-0.71
(>1 Variable
positive)
Sutlive et al.
5-Part Clinical
Symptomatic
2008 [15]
Prediction Rule c
Osteoarthritis
Radiography
0.46
0.89
(>2 Variables
Positive)
Sutlive et al.
5-Part Clinical
Symptomatic
2008 [15]
Prediction Rule c
Osteoarthritis
Radiography
0.68
0.88
(>3 Variables
Positive)
Sutlive et al.
5-Part Clinical
Symptomatic
2008 [15]
Prediction Rule c
Osteoarthritis
Radiography
(>4 Variables
Positive)
0.91
0.82
145.01
Sutlive et al.
5-Part Clinical
Symptomatic
2008 [15]
Prediction Rule c
Osteoarthritis
Radiography
0.14
0.98
0.06-0.18
0.95-1.00
3/21
50/51
0.96
0.86
0.94-0.97
0.74-0.93
245/ 255
30/35
0.75
0.74
(All 5 Variables
7.29
0.87
1.09-
0.82-1.00
50.33
Positive)
Tiru et al.
Patellar-Pubic
Traumatic
Repeat
2002 [16]
Percussion Testd
Fracture
Radiography,
(Radiologically
Bone
Occult)
Scintigraphy,
0.98
0.75
6.73
0.05
3.61-
0.03-0.08
14.00
MRI or CT
Table Legend:
Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (+LR), Negative Likelihood Ratio (-LR), 95% Confidence
Interval (95%CI), True Positives (TP), False Positives (FP), True Negatives (TN), False Negatives (FN), Range of Motion (ROM). All values rounded to 2
decimal places. When one of the cells of the 2x2 contingency table contained the value ‘zero’, we added 0.5 to each cell in order to calculate likelihood ratio
values and their confidence intervals.
a
10 healthy controls that tested negative with the index test were removed from our calculations
Description of the Hip Abduction Sign in study by Khadilkar and Singh [10]: “Patients were asked to rise from the ground while they were observed from
the front. After the initial efforts to get off the ground, as they began to climb up on their thighs, abduction of hip joints and thighs was noted. The test was
considered positive when the angle subtended by both knees was more than 90o (that is, 45o on each side of the midline)”
b
c
Clinical Prediction Rule consisted of 5 variables: (1) self-reported squatting as an aggravating factor, (2) scour test with adduction causing groin or lateral
pain, (3) active hip flexion causing late pain, (4) active hip extension causing hip pain, and (5) passive hip internal rotation less than or equal to 25o.
Description of the Patellar Pubic Percussion test in the study by Tiru et al. [16]: “The test was performed by percussing the patella and simultaneously
auscultating with the bell of the stethoscope over the pubic symphysis. The percussion note was then compared over the contralateral side in a similar
fashion. A positive test was one that resulted in diminished percussion note on the side of pain felt and a negative test was defined as one in which no
difference in percussion note was obtained.”
d
References:
1.
Adams SL, Yarnold PR: Clinical use of the patellar-pubic percussion sign in hip trauma. The American journal of emergency
medicine 1997, 15:173-175.
2.
Anwar MM, Sugano N, Masuhara K, Kadowaki T, Takaoka K, Ono K: Total hip arthroplasty in the neglected congenital dislocation
of the hip. A five- to 14-year follow-up study. Clinical orthopaedics and related research 1993:127-134.
3.
Bache JB, Cross AB: The Barford test. A useful diagnostic sign in fractures of the femoral neck. The Practitioner 1984, 228:305308.
4.
Bird PA, Oakley SP, Shnier R, Kirkham BW: Prospective evaluation of magnetic resonance imaging and physical examination
findings in patients with greater trochanteric pain syndrome. Arthritis and rheumatism 2001, 44:2138-2145.
5.
Birrell F, Croft P, Cooper C, Hosie G, Macfarlane G, Silman A: Predicting radiographic hip osteoarthritis from range of movement.
Rheumatology (Oxford, England) 2001, 40:506-512.
6.
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7.
Hananouchi T, Yasui Y, Yamamoto K, Toritsuka Y, Ohzono K: Anterior impingement test for labral lesions has high positive
predictive value. Clin Orthop 2012, 470:3524-3529.
8.
Holla JF, van der Leeden M, Roorda LD, Bierma-Zeinstra SM, Damen J, Dekker J, Steultjens MP: Diagnostic accuracy of range of
motion measurements in early symptomatic hip and/or knee osteoarthritis. Arthritis Care Res (Hoboken) 2012, 64:59-65.
9.
Hossain M, Barwick C, Sinha AK, Andrew JG: Is magnetic resonance imaging (MRI) necessary to exclude occult hip fracture?
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10.
Khadilkar SV, Singh RK: Hip abduction sign: a new clinical sign in sarcoglycanopathies. Journal of clinical neuromuscular disease
2001, 3:13-15.
11.
Narvani AA, Tsiridis E, Kendall S, Chaudhuri R, Thomas P: A preliminary report on prevalence of acetabular labrum tears in
sports patients with groin pain. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2003, 11:403-408.
12.
Olsson SS, Jernberger A, Tryggo D: Clinical and radiological long-term results after Charnley-Muller total hip replacement. A 5 to
10 year follow-up study with special reference to aseptic loosening. Acta orthopaedica Scandinavica 1981, 52:531-542.
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Roder C, Eggli S, Aebi M, Busato A: The validity of clinical examination in the diagnosis of loosening of components in total hip
arthroplasty. The Journal of bone and joint surgery British volume 2003, 85:37-44.
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Shin AY, Morin WD, Gorman JD, Jones SB, Lapinsky AS: The superiority of magnetic resonance imaging in differentiating the
cause of hip pain in endurance athletes. The American journal of sports medicine 1996, 24:168-176.
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Tiru M, Goh SH, Low BY: Use of percussion as a screening tool in the diagnosis of occult hip fractures. Singapore medical journal
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