Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome

Review written by Dr Joanne Kemp info

Key Points

  1. Impingement tests, specifically the Anterior Impingement Test (AIMT) and Flexion/Adduction/Internal Rotation (FADIR) test, can be used in combination with the internal rotation test in prone, to help diagnose people with hip pain as having femoroacetabular impingement syndrome (FAIS).
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BACKGROUND & OBJECTIVE

The diagnosis of causes of hip and groin pain is challenging. This is due to the complex anatomy of the region, the possibility of multiple structures causing pain, and the likelihood of the presence of co-existing pathologies (1). Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain in young and middle-aged adults and is associated with an increased risk of developing hip osteoarthritis (OA) (2). FAIS should be diagnosed by a combination of hip bone shape (morphology), the presence of pain and symptoms, and objective signs such as loss of range of motion (3). The diagnostic accuracy of impingement and range of motion tests in people with FAIS is uncertain.

Therefore, the aim of this paper was to (1) evaluate the reliability of a clinical assessment of the hip; and (2) evaluate the diagnostic accuracy of impingement and range of motion tests of the hip, in detecting people with FAIS.

Femoroacetabular impingement syndrome is associated with an increased risk of developing hip osteoarthritis.
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Clinicians can add the internal rotation ROM test to the FADIR test as part of their clinical assessment to help confirm the diagnosis of FAIS.

METHODS

The researchers recruited 81 patients (mean age 36 years, 49% women) with hip pain who had attended an orthopaedic clinic over a 3-year period. To be included, the patients needed to be aged 18-55 years, and had pain for at

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