Diagnostic Accuracy of Patient History in the Diagnosis of Hip-Related Pain : A Systematic Review / Alexis A. Wright, Brandon M. Ness, Megan Donaldson

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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.
Archives of Physical Medicine and Rehabilitation 2021;000:1−11

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