BACKGROUND & OBJECTIVE
In order to design an appropriate treatment for hip pain, there needs to be accuracy and consistency in the diagnostic testing. The authors of this paper identified a lack of precision in the diagnosis of hip dysplasia and instability. This systematic review summarizes the clinical and imaging tests for hip dysplasia and provides a reference for clinicians in the design of care.
The authors conducted this study according to proper standards. The data extraction system (PRISM-DTA) used by the authors is designed to facilitate transparency. This helps reduce the risk of bias in the review.
- Criteria for inclusion: participants between 13 and 65 years with hip pain, diagnosed as hip dysplasia or instability using a reference standard.
- Criteria for exclusion: participants with congenitally-related conditions, diagnostic tests with non-standardized instrumentation, and cadaver studies.
There is more than one reference standard for the diagnosis of dysplasia. The authors pointed to the center edge angle (CEA) of Wiberg < 200 measured on antero-posterior radiograph of the pelvis to diagnose dysplasia. Values between 200 - 250 are used to diagnose border-line dysplasia.
The authors state that there is no objective or radiological signs specific to hip instability. Clinical diagnosis relies on a broad range of factors and presentation can be subtle. The authors looked for clinical testing consistency and diagnostic accuracy.
Seven studies (n=965) met the inclusion criteria following the full review process.