M P Reiman1,2,3, K Thorborg4,5, K Covington6, C E Cook6, P Hölmich4,7. 1. Department of Orthopedic Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC, USA. reiman.michael@gmail.com. 2. Sports Orthopedic Research Centre-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark. reiman.michael@gmail.com. 3. Doctor of Physical Therapy Division, Department of Medicine, Duke University School of Medicine, DUMC 104002, Durham, NC, 27710, USA. reiman.michael@gmail.com. 4. Sports Orthopedic Research Centre-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark. 5. Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), and Departments of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark. 6. Department of Orthopedic Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC, USA. 7. Aspetar Sports Groin Pain Center, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
Abstract
PURPOSE: Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. METHODS: A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally defined from international publications and presentations was utilized. RESULTS: All six domains (subjective examination, patient-reported outcome measures, physical examination, special tests, physical performance measures, and diagnostic imaging) had at least one descriptor with 75% consensus agreement for diagnosis and assessment of FAIS. Diagnostic imaging was the domain with the highest level of agreement. Domains such as patient-reported outcome measures (PRO's) and physical examination were identified as non-diagnostic measures (rather as assessments of disease impact). CONCLUSION: Although it also had the greatest level of variability in description of examination domains, diagnostic imaging continues to be the preeminent diagnostic measure for FAIS. No single domain should be utilized as the sole diagnostic or assessment parameter for FAIS. While not all investigated domains provide diagnostic capability for FAIS, those that do not are able to serve purpose as a measure of disease impact (e.g., impairments and activity limitations). The clinical relevance of this Delphi survey is the understanding that a comprehensive assessment measuring both diagnostic capability and disease impact most accurately reflects the patient with FAIS. LEVEL OF EVIDENCE: V.
PURPOSE: Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. METHODS: A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally defined from international publications and presentations was utilized. RESULTS: All six domains (subjective examination, patient-reported outcome measures, physical examination, special tests, physical performance measures, and diagnostic imaging) had at least one descriptor with 75% consensus agreement for diagnosis and assessment of FAIS. Diagnostic imaging was the domain with the highest level of agreement. Domains such as patient-reported outcome measures (PRO's) and physical examination were identified as non-diagnostic measures (rather as assessments of disease impact). CONCLUSION: Although it also had the greatest level of variability in description of examination domains, diagnostic imaging continues to be the preeminent diagnostic measure for FAIS. No single domain should be utilized as the sole diagnostic or assessment parameter for FAIS. While not all investigated domains provide diagnostic capability for FAIS, those that do not are able to serve purpose as a measure of disease impact (e.g., impairments and activity limitations). The clinical relevance of this Delphi survey is the understanding that a comprehensive assessment measuring both diagnostic capability and disease impact most accurately reflects the patient with FAIS. LEVEL OF EVIDENCE: V.
Entities:
Keywords:
Assessment; Examination; Femoroacetabular impingement; Hip
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Authors: Michael P Reiman; Rintje Agricola; Joanne L Kemp; Joshua J Heerey; Adam Weir; Pim van Klij; Ara Kassarjian; Andrea B Mosler; Eva Ageberg; Per Hölmich; Kristian Marstrand Warholm; Damian Griffin; Sue Mayes; Karim M Khan; Kay M Crossley; Mario Bizzini; Nancy Bloom; Nicola C Casartelli; Laura E Diamond; Stephanie Di Stasi; Michael Drew; Daniel J Friedman; Matthew Freke; Sion Glyn-Jones; Boris Gojanovic; Marcie Harris-Hayes; Michael A Hunt; Franco M Impellizzeri; Lasse Ishøi; Denise M Jones; Matthew G King; Peter R Lawrenson; Michael Leunig; Cara L Lewis; Nicolas Mathieu; Håvard Moksnes; May Arna Risberg; Mark J Scholes; Adam I Semciw; Andreas Serner; Kristian Thorborg; Adam Virgile; Tobias Wörner; H Paul Dijkstra Journal: Br J Sports Med Date: 2020-08-31 Impact factor: 13.800