Abstract
Objective
To investigate the diagnostic accuracy of patient history associated with hip pain.
Data Sources
A systematic, computerized search of electronic databases (PubMed, MEDLINE, Cumulative
Index of Nursing and Allied Health Literature, and Web of Science), a search of the
gray literature, and review of the primary author's personal library was performed.
Hip-specific search terms were combined with diagnostic accuracy and subjective or
self-report history-based search terms using the Boolean operator “AND.”
Study Selection
This systematic review was conducted and reported according to the protocol outlined
by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
The inclusion criteria were: (1) patients with hip pain; (2) the statistical association
of at least 1 patient history item was reported; (3) study designs appropriate for
diagnostic accuracy; (4) adults aged ≥18 years; (5) written in English; and (6) used
an acceptable reference standard for diagnosed hip pathology. Titles and abstracts
of all database-captured citations were independently screened by at least 2 reviewers.
Data Extraction
Two reviewers independently extracted information and data regarding author, year,
study population, study design, criterion standard, and strength of association statistics
associated with the subjective findings.
Data Synthesis
For hip osteoarthritis (OA), a family history of OA (positive likelihood ratio [+LR],
2.13), history of knee OA (+LR, 2.06), report of groin or anterior thigh pain (+LR,
2.51-3.86), self-reported limitation in range of motion of 1 or both hips (+LR, 2.87),
constant low back pain or buttock pain (+LR, 6.50), groin pain on the same side (+LR,
3.63), and a screening questionnaire (+LR, 3.87-13.29) were the most significant findings.
For intra-articular hip pathology, crepitus (+LR, 3.56) was the most significant finding.
Conclusions
Patient history plays a key role in differential diagnosis of hip pain and in some
cases can be superior to objective tests and measures.
Keywords
List of abbreviations:
FAI (femoroacetabular impingement), LR (likelihood ratio), OA (osteoarthritis), OR (odds ratio), QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies), SP (specificity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 27, 2021
Footnotes
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
