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ISSN: 2161-0533

Orthopedic & Muscular System: Current Research
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Research Article

Diagnostic Validity of the Physical Examination Maneuvers for Hip Pathology: A Systematic Review

Nick Pasic1*, Dianne Bryant1,2, Douglas Naudie3 and Kevin Willits1,4

1Department of Kinesiology, The University of Western Ontario, London, Canada

2School of Physical Therapy, The University of Western Ontario, London, Canada

3Division of Orthopaedic Surgery, London Health Sciences Center, University Hospital, London, Canada

4Division of Orthopaedic Surgery, The University of Western Ontario, London, Canada

*Corresponding Author:
Nick Pasic
Department of Kinesiology
Faculty of Health Sciences
The University of Western Ontario
3M Centre Rm. 2230, London ON, Canada
E-mail: [email protected]

Received Date: May 23, 2014; Accepted Date: June 25, 2014; Published Date: June 30, 2014

Citation: Pasic N, Bryant D, Naudie D, Willits K (2014) Diagnostic Validity of the Physical Examination Maneuvers for Hip Pathology: A Systematic Review. Orthopedic Muscul Syst 3: 157. doi: 10.4172/2161-0533.1000157

Copyright: © 2014 Pasic N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: There is a number of physical examination maneuvers used to diagnose hip pathology but the diagnostic validity of these maneuvers is unclear. We conducted a systematic review to evaluate current knowledge regarding the diagnostic validity of the physical examination maneuvers for hip pathology.

Methods: We conducted a literature search of the electronic databases MEDLINE, CINAHL, EMBASE, Cochrane, and SPORTDiscus. The methodological quality of each eligible study was assessed and classified according to Sackett and Haynes’ phases of diagnostic research, whereby Phase I and II studies represent proof of concept and Phase III studies are applicable to a clinical setting.

Results: Eight studies were classified as phase III diagnostic studies, four of which were methodologically rigorous. In diagnosing labral tears of the hip, neither the impingement test (sensitivity=0.51-0.78, specificity=0.10-0.89) nor FABER test (sensitivity=0.60, specificity=0.75) demonstrated evidence to support the use of these tests clinically. In diagnosing gluteal tendon pathology the Trendelenburg test demonstrated some evidence for use in a clinical setting (sensitivity=0.23-0.73, specificity=0.77-0.94).

Conclusion: The diagnostic validity of clinical tests to diagnose the presence or absence of hip pathology remains uncertain. The majority of studies supporting validity of these tests lacked methodological rigor, and thus cannot provide evidence to support the use of a test in clinical practice.


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