骨科与肌肉系统：当前研究
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髋关节病理学体检操作的诊断有效性：系统评价

尼克·帕西克、黛安·布莱恩特、道格拉斯·诺迪和凯文·威利茨

背景：有许多体检方法可用于诊断髋关节病理，但这些方法的诊断有效性尚不清楚。我们进行了系统评价，以评估有关髋关节病理体检操作诊断有效性的现有知识。

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.