Table 3

Summary of articles reporting on the diagnostic accuracy of OSTs for hip impingement/labral tear tests

Test, authorsParticipantsSN/SP (95% CI)+LR/−LRPPV/NPVReference standardPre to post-test probability
Anterior impingement—labral tear (FADDIR) test
 Aprato et al654199 (88 to 99)/6 (1 to 40)*1.1/0.22*82.1
(68 to91)/50 (6 to 95)
MRA (FAI)Pretest=80%
Post-test=82.1%
 Barton et al666899 (90 to 100)/2 (0 to 16)*1.0/0.59*63 (51 to 74)/50 (6 to 95)MRA (α angle>50.5°) for FAIPretest=62.1%
Post-test=63%
 Beaule et al8130100/all (+) (FAI)
99 (88 to 100)/25 (3 to 80)* (labral tear)
NA/NA (FAI)
1.3/0.06* (labral tear)
96 (84 to 99)/50 (5 to 95)MRA
(labral tear)
Pretest=93.4%
Post-test=95.9%
 Domayer et al6749/60 hips99 (90 to 100)/3 (0 to 24)*1.0/0.35*75 (62 to 84)/50 (5 to 95)MRI (α angle >55°) for FAIPretest=73.4%
Post-test=74.6%
 Hananouchi et al7569/107 hips56 (37 to 73)/83 (31 to 98)*3.3/0.53*97 (75 to 100)MRI (FAI)Pretest=92.6%
Post-test=96.7%
 Keeney et al6810199 (94 to 100)/2 (0 to 18)*1.0/0.3*76 (66 to 84)/50 (5 to 95)MRA (labral tear)Pretest=75.3%
Post-test=76.1%
 Laude et al6997/100 hips99 (95 to 100)/6 (0 to 40)*1.1/0.09*93 (86 to 96)/50 (5 to 95)Arthroscopy (labral tear)Pretest=91.7%
Post-test=92.6%
 Leunig et al762397 (79 to 100)/13 (1 to 60)*1.1/0.23*84 (64 to 94)/50 (5 to 95)Surgery (labral tear)Pretest=80.4%
Post-test=84.1%
 Martin et al7710578 (59 to 89)/10 (3 to 29)0.86/2.353 (38 to 67)/25 (7 to 59)Intra-articular injection (FAI and labral tear)Pretest=43.8%
Post-test=52.5%
 Peters et al7194/96 hips99 (95 to 100)/3 (0 to 25)*1.0/0.18*85 (77 to 91)/50 (5 to 95)Surgery
(FAI)
Pretest=84.2%
Post-test=85.1%
 Sink et al723599 (87 to 100)/17 (2 to 69)* (FAI)
97 (77 to 100)/4 (0 to 28)* (labral tear)
1.2/0.09* (FAI)
1.0/0.76* (labral tear)
57 (39 to 73)/50 (5 to 95)AP radiograph (pincer FAI)
MRI (labral tear)
Pretest=55.0%
Post-test=56.9%
 Troelsen et al791858 (36 to 78)/75 (20 to 97) *2.3/0.56*96 (68 to 100)/17 (4 to 49)MRA (labral tear)Pretest=94.4%
Post-test=95.5%
 Wang et al732196 (73 to 99)/6 (1 to 37)*
FAI
1.0/0.7*61 (41 to 79)/50 (5 to 95)Radiographs (labral tear)Pretest=58.7%
Post-test=61.4%
Bilateral LE squat (maximum depth)
 Ayeni et al807675 (58 to 87)/41 (28 to 56)*1.3/0.61*47.1 (34.1, 60.5)/70.4 (51.5, 84.1)MRI or MRA (FAI)Pretest=41%
Post-test=47.1%
FABER test
 Maslowski et al785052.5 (37.5 to 67.1)/54.5 (28 to 78.7)1.1/0.7280.8 (62.1, 91.5)/24 (11.5, 43.4)Intra-articular injection (FAI and labral tear)Pretest=78.0%
Post-test=80.8%
 Martin et al7710560 (41 to 77)/18 (7 to 39)0.73/2.245.5 (29.8, 62.0)/28.6 (11.7, 54.6)Intra-articular injection (FAI and labral tear)Pretest=31.9%
Post-test=45.5%
 Troelsen et al791842 (22 to 64)/75 (20 to 97)*1.7/0.78*93.8 (59.8, 99.3)/12.5 (2.9, 40.2)MRA (labral tear)Pretest=94.4%
Post-test=93.8%
Flexion-internal rotation test
 Chan et al743098 (84 to 100)/8 (1 to 48)*1.1/0.23*82.3 (65.6, 91.9)MRA
(labral tear)
Pretest=79.7%
Post-test=82.3%
 Chan et al741797 (77 to 100)/25 (3 to 80)*1.3/0.12*91.7 (70.6, 98.1)/50 (5.5, 95.5)Arthroscopy (labral tear)Pretest=86.8%
Post-test=91.7%
 Nogier et al6424170 (62 to 77)/44 (34 to 54)1.3/0.6967.9 (60.3, 74.8)/46.4 (36.2, 57.0)Radiographs (FAI)Pretest=44.2%
Post-test=67.9%
 Petersilge et al631095 (66 to 100)/25 (3 to 80)1.3/0.2086.4 (57.1, 96.8)/50 (5.5, 94.5)Arthroscopy (labral tear)Pretest=79.2
Post-test=86.4%
Internal rotation-flexion-axial compression test
 Narvani et al51875 (19 to 99)/43 (18 to 72)*1.3/0.58*27.3 (9.7, 56.6)/85.7 (48.7, 97.4)MRA (labral tear)Pretest=16.7%
Post-test=27.3%
Internal rotation with overpressure
 Maslowski et al785091 (68 to 99)/18 (5 to 40)1.1/0.545.5 (31.7, 59.9)/71.4 (35.9, 91.8)Intra-articular injection (FAI and labral tear)Pretest=39.2%
Post-test=45.5%
Resisted straight leg raise test
 Maslowski et al785058 (34 to 79)/29 (11 to 54)0.87/1.2840.6 (25.5, 57.7)/50 (29, 71)Intra-articular injection (FAI and labral tear)Pretest=44%
Post-test=40.6%
Scour test
 Maslowski et al785050 (26 to 74)/29 (12 to 51)0.70/1.7235.5 (21.1, 53.1)/42.1 (23.1, 63.7)Intra-articular injection (FAI and labral tear)Pretest=22%
Post-test=35.5%
THIRD test
 Myrick and Nissen7010098 (93 to 100)/75 (19 to 99)3.9/0.03*98.9 (94.3, 99.8)/60 (23.1, 88.2)Arthroscopy (labral tear)Pretest=94%
Post-test=98.9%
Thomas test
 McCarthy and Busconi35989 (73 to 97)/92 (75 to 99)*11.1/0.12*94 (80 to 99)/86 (67 to 96)*Arthroscopy (labral tear)
Trochanteric tenderness (not tender)
 Martin et al7710557 (39 to 74)/45 (27 to 65)1.1/0.9355.6 (37.7, 72.4)/47.6 (28.3, 67.6)Intra-articular injection (FAI and labral tear)Pretest=54.2%
Post-test=55.6%
  • *Calculations performed by authors of this study.

  • ARS, acetabular rim syndrome; F, female; FABER, flexion, abduction, external rotation test; FADDIR, flexion-adduction-internal rotation impingement test, LE, lower extremity; +LR, positive likelihood ratio; −LR, negative likelihood ratio; MRA, MR angiogram; NA, not applicable; NPV, negative predictive value; NR, not reported; OST, orthopaedic special tests; PPV, positive predictive value; SN, sensitivity (%); SP, specificity (%);VAS, visual analogue scale.