Department of Orthopedic Surgery, Kansai Rosai Hospital, 1-69 Inabasou 3 Chome, Amagasaki, Hyogo 660-8511, Japan.
Clin Orthop Relat Res. 2012 Dec;470(12):3524-9. doi: 10.1007/s11999-012-2450-0. Epub 2012 Jul 6.
The anterior impingement test is intended to detect anterosuperior acetabular labral lesions. In patients treated for labral lesions its sensitivity is reportedly 95% to 100%, and in a small group of patients undergoing periacetabular osteotomy, its sensitivity was 59% and specificity 100%. However, the sensitivity, specificity, positive predictive value, and negative predict value of this test to detect these labral lesions in unselected patients with hip pain are unknown.
QUESTIONS/PURPOSES: We investigated these four parameters (1) in unselected patients with hip pain, and (2) in three subgroups of patients with dysplasia, femoroacetabular impingement (FAI), and with an intact joint space.
We prospectively studied 69 patients (15 men and 54 women) with a mean age of 57.2 years (range, 27-81 years). One observer performed the anterior impingement test in all patients. We determined the presence or absence of an anterosuperior labral lesion with radial MRI in 107 hips (38 patients in both hips: 14 with pain, and 24 without pain). We also investigated the parameters in the three subgroups which consisted of 60 cases of dysplasia, 27 cases of FAI, and 80 cases with intact joint space; the third subgroup partially overlapped the first and second subgroups.
The four parameters in all hips were 50.6% (45/89), 88.9% (16/18), 95.7% (45/47), and 26.7% (16/60), respectively. Parameters in the three subgroups were similar to those of all cases.
Although the sensitivity of the anterior impingement test did not reach a sufficient level for detecting anterosuperior labral lesions, we believe the high positive predictive value makes the test useful.
Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
前撞击试验旨在检测前上髋臼唇病变。在接受唇病变治疗的患者中，其敏感性据报道为 95%至 100%，而在一小部分接受髋臼周围截骨术的患者中，其敏感性为 59%，特异性为 100%。然而，在未选择的髋痛患者中，该试验检测这些唇病变的敏感性、特异性、阳性预测值和阴性预测值尚不清楚。
问题/目的：我们研究了这四个参数：（1）在未选择的髋痛患者中；（2）在发育不良、股骨髋臼撞击症和关节间隙完整的三组患者中。
我们前瞻性研究了 69 例患者（15 例男性，54 例女性），平均年龄 57.2 岁（范围，27-81 岁）。一位观察者对所有患者进行了前撞击试验。我们通过 107 髋的径向 MRI 确定了前上唇病变的存在或不存在（38 髋来自 38 例患者：14 例有疼痛，24 例无疼痛）。我们还在三个亚组中研究了这些参数，包括 60 例发育不良、27 例股骨髋臼撞击症和 80 例关节间隙完整的患者；第三亚组部分与第一和第二亚组重叠。
所有髋部的四个参数分别为 50.6%（45/89）、88.9%（16/18）、95.7%（45/47）和 26.7%（16/60）。三个亚组的参数与所有病例相似。
尽管前撞击试验的敏感性未达到检测前上唇病变的足够水平，但我们认为其高阳性预测值使其具有实用性。
III 级，诊断研究。有关证据水平的完整描述，请参阅作者指南。
