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Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018.

  • Reiman MP Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA reiman.michael@gmail.com.
  • Agricola R Department of Orthopaedic Surgery, Erasmus, MC, University Medical Center, Rotterdam, Netherlands.
  • Kemp JL La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Heerey JJ La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Weir A Orthopaedics, Erasmus MC Center for Groin Injuries, Rotterdam, The Netherlands.
  • van Klij P Department of Orthopaedic Surgery, Erasmus, MC, University Medical Center, Rotterdam, Netherlands.
  • Kassarjian A Elite Sports Imaging SL, Madrid, Spain.
  • Mosler AB La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Ageberg E Sport Sciences, Deparment of Health Sciences, Lund University, Lund, Sweden.
  • Hölmich P Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
  • Warholm KM Oslo University Hospital, Oslo, Norway.
  • Griffin D Orthopaedics - Medical School, University of Warwick, Coventry, UK.
  • Mayes S La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Khan KM Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada.
  • Crossley KM La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Bizzini M Research, Schulthess Clinic Human Performance Lab, Zurich, Switzerland.
  • Bloom N Physical Therapy, Washington University, St. Louis, Missouri, USA.
  • Casartelli NC Human Performance Lab, Schulthess Clinic, Zurich, Switzerland.
  • Diamond LE Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland Griffith University, Schoold of Allied Health Sciences, Griffith, Queensland, Australia.
  • Di Stasi S School of Health and Rehabilitation Sciences, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • Drew M Athlete Availability, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia.
  • Friedman DJ Alfred Health, Melbourne, Victoria, Australia.
  • Freke M School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.
  • Gojanovic B Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Geneva, Switzerland.
  • Glyn-Jones S Department of Orthopaedic Surgery, University of Oxford, Institute of Musculoskeletal Sciences, Oxford, United Kingdom.
  • Harris-Hayes M Physical Therapy, Washington University, St. Louis, Missouri, USA.
  • Hunt MA Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
  • Impellizzeri FM Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
  • Ishøi L Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
  • Jones DM La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • King MG La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Lawrenson PR School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.
  • Leunig M Department of Orthopaedics, Schulthess Klinik, Zurich, Switzerland.
  • Lewis CL Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA.
  • Mathieu N Physiotherapy, HES-SO Valais, University of Applied Sciences Western Switzerland, Loeche-les-Bains, Valais, Switzerland.
  • Moksnes H Oslo Sports Trauma Research Center, Oslo, Norway.
  • Risberg MA Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
  • Scholes MJ La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Semciw AI La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
  • Serner A Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
  • Thorborg K Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
  • Wörner T Department of Health Sciences, Lund University, Lund, Sweden.
  • Dijkstra HP Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
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  • 2020-01-22
Published in:
  • British journal of sports medicine. - 2020
consensus
examination
hip
Adult
Arthralgia
Biomedical Research
Hip
Humans
Middle Aged
Patient Reported Outcome Measures
Young Adult
English There is no agreement on how to classify, define or diagnose hip-related pain-a common cause of hip and groin pain in young and middle-aged active adults. This complicates the work of clinicians and researchers. The International Hip-related Pain Research Network consensus group met in November 2018 in Zurich aiming to make recommendations on how to classify, define and diagnose hip disease in young and middle-aged active adults with hip-related pain as the main symptom. Prior to the meeting we performed a scoping review of electronic databases in June 2018 to determine the definition, epidemiology and diagnosis of hip conditions in young and middle-aged active adults presenting with hip-related pain. We developed and presented evidence-based statements for these to a panel of 37 experts for discussion and consensus agreement. Both non-musculoskeletal and serious hip pathological conditions (eg, tumours, infections, stress fractures, slipped capital femoral epiphysis), as well as competing musculoskeletal conditions (eg, lumbar spine) should be excluded when diagnosing hip-related pain in young and middle-aged active adults. The most common hip conditions in young and middle-aged active adults presenting with hip-related pain are: (1) femoroacetabular impingement (FAI) syndrome, (2) acetabular dysplasia and/or hip instability and (3) other conditions without a distinct osseous morphology (labral, chondral and/or ligamentum teres conditions), and that these terms are used in research and clinical practice. Clinical examination and diagnostic imaging have limited diagnostic utility; a comprehensive approach is therefore essential. A negative flexion-adduction-internal rotation test helps rule out hip-related pain although its clinical utility is limited. Anteroposterior pelvis and lateral femoral head-neck radiographs are the initial diagnostic imaging of choice-advanced imaging should be performed only when requiring additional detail of bony or soft-tissue morphology (eg, for definitive diagnosis, research setting or when planning surgery). We recommend clear, detailed and consistent methodology of bony morphology outcome measures (definition, measurement and statistical reporting) in research. Future research on conditions with hip-related pain as the main symptom should include high-quality prospective studies on aetiology and prognosis. The most common hip conditions in active adults presenting with hip-related pain are: (1) FAI syndrome, (2) acetabular dysplasia and/or hip instability and (3) other conditions without distinct osseous morphology including labral, chondral and/or ligamentum teres conditions. The last category should not be confused with the incidental imaging findings of labral, chondral and/or ligamentum teres pathology in asymptomatic people. Future research should refine our current recommendations by determining the clinical utility of clinical examination and diagnostic imaging in prospective studies.
Language
  • English
Open access status
bronze
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Persistent URL
https://folia.unifr.ch/global/documents/177559
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