Physical Examination of the Hip: Assessment of Femoroacetabular Impingement, Labral Pathology, and Microinstability

被引:9
|
作者
Wong, Stephanie E. [1 ]
Cogan, Charles J. [1 ]
Zhang, Alan L. [1 ]
机构
[1] Univ Calif San Francisco, Dept Orthopaed Surg, 1500 Owens St, San Francisco, CA 94158 USA
关键词
Physical examination of the hip; Femoroacetabular impingement syndrome; Hip microinstability; hip arthroscopy; provocative maneuvers; CLINICAL-EVALUATION; DIAGNOSIS; MOTION; RANGE; GAIT; TESTS; BIOMECHANICS; RELIABILITY; ULTRASOUND; VALIDITY;
D O I
10.1007/s12178-022-09745-8
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose of Review Determining the correct diagnosis can be challenging in patients presenting with hip pain. The physical examination is an essential tool that can aid in diagnosis of hip pathology. The purpose of this review is to provide an updated summary of recent literature on the physical exam of the hip, particularly as it relates to diagnosis of femoroacetabular impingement (FAI) syndrome, labral injury, and hip microinstability. Recent Findings Physical exam findings consistent with the diagnosis of FAI include reduced supine hip internal rotation and positive flexion-adduction-internal rotation maneuvers. Labral tears can be detected on exam with the Scour test. Studies demonstrate altered hip biomechanics in patients with FAI during activities such as walking and squatting. Those with FAI have slower squat velocities, slower sit-to-stand tests, and increased hip flexion moments during ambulation. Hip microinstability is a dynamic process, which can occur after prior hip arthroscopy. For hip microinstability, the combination of the three following positive tests (anterior apprehension, abduction-extension-external rotation, and prone external rotation) is associated with a 95% likelihood of microinstability as confirmed by examination under anesthesia at the time of surgery. A comprehensive hip physical exam involves evaluation of the hip in multiple positions and assessing hip range of motion, strength, as well as performing provocative testing. A combination of physical exam maneuvers is necessary to accurately diagnose FAI syndrome and labral pathology as individual tests vary in their sensitivity and specificity. While an elevated level of suspicion is needed to diagnose hip microinstability, the provocative tests for microinstability are highly specific.
引用
收藏
页码:38 / 52
页数:15
相关论文
共 50 条
  • [1] Physical Examination of the Hip: Assessment of Femoroacetabular Impingement, Labral Pathology, and Microinstability
    Stephanie E. Wong
    Charles J. Cogan
    Alan L. Zhang
    Current Reviews in Musculoskeletal Medicine, 2022, 15 : 38 - 52
  • [2] Diagnostics of Femoroacetabular Impingement and Labral Pathology of the Hip: A Systematic Review of the Accuracy and Validity of Physical Tests
    Tijssen, Marsha
    van Cingel, Robert
    Willemsen, Linn
    de Visser, Enrico
    ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2012, 28 (06): : 860 - 871
  • [3] Labral hypertrophy correlates with borderline hip dysplasia and microinstability in femoroacetabular impingement: a matched case-control analysis
    Nwachukwu, Benedict U.
    Gaudiani, Michael A.
    Marsh, Nathan A.
    Ranawat, Anil S.
    HIP INTERNATIONAL, 2019, 29 (02) : 198 - 203
  • [4] Hip microinstability and its association with femoroacetabular impingement: A scoping review
    Caliesch, Rahel
    Beckwee, David
    Taeymans, Jan
    Schwab, Joseph M.
    Renaud, Thomas
    Brossard, Quentin
    Hilfiker, Roger
    ARCHIVES OF PHYSIOTHERAPY, 2024, 14 (01) : 29 - 46
  • [5] Imaging of Femoroacetabular Impingement and Acetabular Labral Tears of the Hip
    Lazarus, Martin L.
    DM DISEASE-A-MONTH, 2012, 58 (09): : 495 - 542
  • [6] Navigating the nonarthritic hip: Labral tears and femoroacetabular impingement
    Crown, Taylor
    Lodhia, Parth
    McConkey, Mark
    BRITISH COLUMBIA MEDICAL JOURNAL, 2023, 65 (10): : 376 - 381
  • [7] Hip arthroscopy and labral treatment in patients with femoroacetabular impingement
    Philippon, M. J.
    Schroder, B. G.
    Souza, E.
    Briggs, K. K.
    MINERVA ORTOPEDICA E TRAUMATOLOGICA, 2009, 60 (04) : 293 - 302
  • [8] Decreased Synovial Inflammation in Atraumatic Hip Microinstability Compared With Femoroacetabular Impingement
    Abrams, Geoffrey D.
    Luria, Ayala
    Sampson, Joshua
    Madding, Rachel A.
    Robinson, William H.
    Safran, Marc R.
    Sokolove, Jeremy
    ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2017, 33 (03): : 553 - 558
  • [9] Labral tears in hip dysplasia and femoroacetabular impingement: A systematic review
    Savoye-Laurens, Timothee
    Verdier, Nicolas
    Wettstein, Michael
    Baulot, Emmanuel
    Gedouin, Jean-Emmanuel
    Martz, Pierre
    ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH, 2023, 109 (04)
  • [10] Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes
    Kemp, Joanne L.
    Makdissi, Michael
    Schache, Anthony G.
    Pritchard, Michael G.
    Pollard, Thomas C. B.
    Crossley, Kay M.
    BRITISH JOURNAL OF SPORTS MEDICINE, 2014, 48 (14) : 1102 - U141