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What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

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Troelsen, Anders ; Mechlenburg, Inger ; Gelineck, John ; Bolvig, Lars ; Jacobsen, Steffen ; Søballe, Kjeld. / What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?. I: Acta Orthopaedica (Print Edition). 2009 ; Bind 80, Nr. 3. s. 314-8.

Bibtex

@article{52bb066aebe4494c942d8ffbfd28b82b,
title = "What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?",
abstract = "BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrography. PATIENTS AND METHODS: We examined 18 patients (18 hips, 2 men, median age 43 (32-56) years) with impingement test, FABER test, resisted straight leg raise test, ultrasound, and MR arthrography. They had had previous periacetabular osteotomies due to symptomatic, acetabular dysplasia. All hips showed no or only slight signs of osteoarthritis (T{\"o}nnis grade 0-1). RESULTS: MR arthrography identified labral tears in 17 of the 18 hips. Ultrasound had a sensitivity of 94{\%}, a positive predictive value of 94{\%}, and was false negative in only 1 case compared to MR arthrography. The impingement test had the best diagnostic ability of the clinical tests, with a sensitivity of 59{\%} and a specificity of 100{\%}. The positive predictive value was 100{\%} while the negative predictive value was 13{\%}. INTERPRETATION: The impingement test is helpful in identifying acetabular labral tears. If this test is negative and if a labral tear is still suspected, ultrasound can reliably diagnose most tears of the acetabular labrum. MR arthrography is indicated in cases where ultrasound is negative, but the patient suffers continued, specific symptoms.",
keywords = "Acetabulum, Adult, Female, Hip Dislocation, Hip Joint, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity",
author = "Anders Troelsen and Inger Mechlenburg and John Gelineck and Lars Bolvig and Steffen Jacobsen and Kjeld S{\o}balle",
year = "2009",
doi = "10.3109/17453670902988402",
language = "English",
volume = "80",
pages = "314--8",
journal = "Acta Orthopaedica (Print Edition)",
issn = "1745-3674",
publisher = "Taylor & Francis Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

AU - Troelsen, Anders

AU - Mechlenburg, Inger

AU - Gelineck, John

AU - Bolvig, Lars

AU - Jacobsen, Steffen

AU - Søballe, Kjeld

PY - 2009

Y1 - 2009

N2 - BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrography. PATIENTS AND METHODS: We examined 18 patients (18 hips, 2 men, median age 43 (32-56) years) with impingement test, FABER test, resisted straight leg raise test, ultrasound, and MR arthrography. They had had previous periacetabular osteotomies due to symptomatic, acetabular dysplasia. All hips showed no or only slight signs of osteoarthritis (Tönnis grade 0-1). RESULTS: MR arthrography identified labral tears in 17 of the 18 hips. Ultrasound had a sensitivity of 94%, a positive predictive value of 94%, and was false negative in only 1 case compared to MR arthrography. The impingement test had the best diagnostic ability of the clinical tests, with a sensitivity of 59% and a specificity of 100%. The positive predictive value was 100% while the negative predictive value was 13%. INTERPRETATION: The impingement test is helpful in identifying acetabular labral tears. If this test is negative and if a labral tear is still suspected, ultrasound can reliably diagnose most tears of the acetabular labrum. MR arthrography is indicated in cases where ultrasound is negative, but the patient suffers continued, specific symptoms.

AB - BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrography. PATIENTS AND METHODS: We examined 18 patients (18 hips, 2 men, median age 43 (32-56) years) with impingement test, FABER test, resisted straight leg raise test, ultrasound, and MR arthrography. They had had previous periacetabular osteotomies due to symptomatic, acetabular dysplasia. All hips showed no or only slight signs of osteoarthritis (Tönnis grade 0-1). RESULTS: MR arthrography identified labral tears in 17 of the 18 hips. Ultrasound had a sensitivity of 94%, a positive predictive value of 94%, and was false negative in only 1 case compared to MR arthrography. The impingement test had the best diagnostic ability of the clinical tests, with a sensitivity of 59% and a specificity of 100%. The positive predictive value was 100% while the negative predictive value was 13%. INTERPRETATION: The impingement test is helpful in identifying acetabular labral tears. If this test is negative and if a labral tear is still suspected, ultrasound can reliably diagnose most tears of the acetabular labrum. MR arthrography is indicated in cases where ultrasound is negative, but the patient suffers continued, specific symptoms.

KW - Acetabulum

KW - Adult

KW - Female

KW - Hip Dislocation

KW - Hip Joint

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Sensitivity and Specificity

U2 - 10.3109/17453670902988402

DO - 10.3109/17453670902988402

M3 - Journal article

VL - 80

SP - 314

EP - 318

JO - Acta Orthopaedica (Print Edition)

JF - Acta Orthopaedica (Print Edition)

SN - 1745-3674

IS - 3

ER -

ID: 32526556