Diagnostic Accuracy of Clinical Tests and Imaging Exams for Femoroacetabular Impingement: An Umbrella Review of Systematic Reviews

医学 股骨髋臼撞击 科克伦图书馆 梅德林 荟萃分析 医学物理学 诊断准确性 系统回顾 循证医学 放射科 关节镜检查 病理 替代医学 政治学 法学
作者
Daniel Araujo Fernandes,Gilberto Melo,Marcos Emílio Kuschnaroff Contreras,Renato Locks,Jorge Chahla,Fabrício Souza Neves
出处
期刊:Clinical Journal of Sport Medicine [Lippincott Williams & Wilkins]
卷期号:32 (6): 635-647 被引量:4
标识
DOI:10.1097/jsm.0000000000000978
摘要

Objective: To synthesize available evidence about diagnostic accuracy of clinical tests and imaging examinations for femoroacetabular impingement (FAI) syndrome. Design: Umbrella review. Setting: N/A. Participants: N/A. Interventions: N/A. Main Outcome Measures: Systematic reviews (SR) indexed in Embase, LIVIVO, PubMed, SCOPUS, the Cochrane Library, and Web of Science were searched in a 2-phase process. SR assessing diagnostic accuracy were considered eligible. Results: From 1520 studies, 6 SR were included, which evaluated 24 primary studies related to FAI syndrome. Of these, 5 SR assessed clinical tests, and a substantial heterogeneity was found concerning reference standards adopted across primary studies, which included arthroscopy, clinical examination (associated or not with imaging exams), intra-articular injections, and open surgery. Most clinical tests presented higher values of sensitivity compared with specificity, although evidence was considered limited because the same primary studies were often included across SR. Nonetheless, evidence around the flexion adduction internal rotation (FADIR) test was considered stronger and its use as a screening tool was consistently supported. Only one SR assessed the accuracy of imaging examinations, which adopted open surgery as the sole reference standard. Most imaging exams presented considerably high values of sensitivity, although specificity values were notably lower. Conclusions: No robust recommendations can be provided for most clinical tests, although the FADIR test, in particular, was consistently supported as a screening tool. Moreover, although imaging examinations showed considerably high sensitivity values, evidence was considered sparse and further research is strongly recommended to validate its use as reference standards for diagnostic accuracy data.

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