Clinical tests to determine femoral version category in people with chronic hip joint pain and asymptomatic controls.
Alexandria Uding, Nancy J Bloom, Paul K Commean and 4 others
PMID 30553987WHAT IT FOUND
Passive hip rotation tests and Craig's test were related to MRI femoral version in adults with and without chronic hip pain.
They may help screen for abnormal version when imaging is unavailable, but do not show that version causes pain.
Key findings
01MRI femoral version was related to all clinical measures except external rotation at 90 degrees of hip flexion, with the neutral hip rotation difference most closely related.
02Hips sorted into MRI femoral version categories differed on rotation measures, except external rotation at 90 degrees of hip flexion.
03People with chronic hip pain and matched asymptomatic controls did not differ in MRI femoral version, Craig's test, or hip rotation measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a secondary analysis of a parent cohort study, and the parent study was powered for hip abductor strength, not for these diagnostic relationships. The analysis included 38 matched pairs after 2 of 80 recruited participants were excluded for MRI problems. The population was relatively homogeneous in age and BMI, and the authors stated broader populations are needed. Most participants were female, and the authors stated this may have impacted results. A single examiner performed MRI measurements and another examiner performed clinical measures, and the authors stated generalization to other examiners may be limited. People with chronic hip pain were included, and the authors stated their range of motion may be affected by their condition. The authors stated they did not take into account other bony abnormalities that may contribute to hip range of motion. The authors stated they do not know if the femoral version categories indicate increased injury risk.
Declared interests
The authors state they have no financial affiliation or involvement with any commercial organization that has a direct financial interest in the manuscript, except as disclosed in an attachment.
The easy way to misread this
Do not assume abnormal femoral version explains chronic hip pain. People with chronic hip pain and matched controls had no differences in MRI femoral version, Craig's test, or hip rotation measures, and the study did not show that the version categories predict injury.