Author(s): Byrd JW, Jones KS
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Abstract BACKGROUND: Hip arthroscopy has defined elusive causes of hip pain. HYPOTHESIS/PURPOSE: It is postulated that the reliability of various investigative methods is inconsistent. The purpose of this study is to evaluate the diagnostic accuracy of these methods. STUDY DESIGN: Retrospective review of prospectively collected data. METHODS: Five parameters were assessed in 40 patients: clinical assessment, high-resolution magnetic resonance imaging, magnetic resonance imaging with gadolinium arthrography, intra-articular bupivacaine injection, and arthroscopy. Using arthroscopy as the definitive diagnosis, the other parameters were evaluated for reliability. RESULTS: Hip abnormality was clinically suspected in all cases with 98\% accuracy (1 false positive). However, the nature of the abnormality was identified in only 13 cases with 92\% accuracy. Magnetic resonance imaging variously demonstrated direct or indirect evidence of abnormality but overall demonstrated a 42\% false-negative and a 10\% false-positive interpretation. Magnetic resonance arthrography demonstrated an 8\% false-negative and 20\% false-positive interpretation. Response to the intra-articular injection of anesthetic was 90\% accurate (3 false-negative and 1 false-positive responses) for detecting the presence of intra-articular abnormality. CONCLUSIONS: In this series, clinical assessment accurately determined the existence of intra-articular abnormality but was poor at defining its nature. Magnetic resonance arthrography was much more sensitive than magnetic resonance imaging at detecting various lesions but had twice as many false-positive interpretations. Response to an intra-articular injection of anesthetic was a 90\% reliable indicator of intra-articular abnormality.
This article was published in Am J Sports Med
and referenced in Journal of Novel Physiotherapies