How Useful Is the Flexion–Adduction–Internal Rotation Test for Diagnosing Femoroacetabular Impingement

2018 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ajaykumar Shanmugaraj ◽  
Jaymee R. Shell ◽  
Nolan S. Horner ◽  
Andrew Duong ◽  
Nicole Simunovic ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Rotation Test

Hip Morphological Characteristics and Range of Internal Rotation in Femoroacetabular Impingement

2012 ◽  
Vol 40 (6) ◽  
pp. 1329-1336 ◽  
Author(s):  
Emmanuel A. Audenaert ◽  
Ian Peeters ◽  
Lara Vigneron ◽  
Nick Baelde ◽  
Christophe Pattyn
Keyword(s):  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Morphological Characteristics

Relationship between the maximum flexion-internal rotation test and the torn acetabular labrum of a dysplastic hip

2002 ◽  
Vol 7 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Eiji Suenaga ◽  
Yasuo Noguchi ◽  
Seiya Jingushi ◽  
Toshihide Shuto ◽  
Yasuharu Nakashima ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Acetabular Labrum ◽  
Maximum Flexion ◽  
Rotation Test ◽  
Dysplastic Hip

scholarly journals Diagnostic accuracy of a new clinical test (resisted internal rotation) for detection of gluteus medius tears

2019 ◽  
Vol 6 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Victor Ortiz-Declet ◽  
Austin W Chen ◽  
David R Maldonado ◽  
Leslie C Yuen ◽  
Brian Mu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Internal Rotation ◽  
Clinical Examination ◽  
Predictive Value ◽  
Gluteus Medius ◽  
Control Group ◽  
Case Group ◽  
Lower Sensitivity ◽  
Clinical Test ◽  
Rotation Test

Abstract The objective of this study was to evaluate the diagnostic accuracy of a new dynamic clinical examination for detection of gluteus medius (GM) tears. A case group of 50 patients undergoing arthroscopy with GM repair was compared with a control group of 50 patients undergoing arthroscopy who had no peritrochanteric symptoms. Both groups were examined clinically, had magnetic resonance imaging studies performed and underwent arthroscopic surgery. Recorded clinical examinations included abnormal gait (Trendelenburg), tenderness to palpation of the greater trochanter, resisted abduction and the test being studied, resisted internal rotation. For all clinical tests, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rates were calculated and compared with the arthroscopic and MRI data for the case group, and the MRI data for the control group. The resisted internal rotation test had a sensitivity of 92%, specificity of 85% and diagnostic accuracy of 88% in the detection of GM tears, with a low rate of false-positive and false-negative recordings. Other traditional clinical examination tests, with the exception of Trendelenburg gait, showed inferior rates. Trendelenburg gait had a higher specificity, but much lower sensitivity. The resisted internal rotation test aides in the detection of GM pathology. Due to the good results of the resisted internal rotation test in all the diagnostic parameters, we recommend incorporating it on the physical exam of patients with hip pain.

Femoroacetabular Impingement Patients With Decreased Femoral Version Have Different Impingement Locations and Intra- and Extraarticular Anterior Subspine FAI on 3D-CT–Based Impingement Simulation: Implications for Hip Arthroscopy

2019 ◽  
Vol 47 (13) ◽  
pp. 3120-3132 ◽  
Author(s):  
Till D. Lerch ◽  
Adam Boschung ◽  
Inga A.S. Todorski ◽  
Simon D. Steppacher ◽  
Florian Schmaranzer ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Hip Impingement ◽  
Femoral Version ◽  
Asymptomatic Control

Background: It remains unclear whether decreased femoral version (FV) causes anterior intra- or extra-articular femoroacetabular impingement (FAI). Therefore, we evaluated symptomatic hips with decreased FV, with and without cam and pincer FAI, by using computed tomography (CT)–based virtual 3-dimensional (3D) impingement simulation and compared this group with patients with normal FV and with asymptomatic hips. Purpose: To investigate (1) the osseous range of motion, (2) the osseous femoral and acetabular impingement zones, and (3) whether hip impingement is extra- or intra-articular in symptomatic hips with FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An institutional review board–approved, retrospective comparative analysis was performed on a total of 84 hips in 68 participants. Of these, 37 hips in 24 symptomatic patients with FAI had decreased FV. These hips were compared with 21 hips of 18 symptomatic patients with anterior FAI with normal FV (10°-25°) and 26 asymptomatic hips with no FAI and normal FV. All patients with FAI were symptomatic and had anterior hip pain and a positive anterior impingement test. They underwent pelvic CT scans to measure FV. Decreased FV was defined as FV less than 5°. The 37 hips with decreased FV presented both with and without cam and pincer FAI. All 84 hips were evaluated by use of CT-based 3D models and a validated 3D range of motion and impingement simulation. Asymptomatic hips were contralateral normal hips imaged in patients undergoing total hip arthroplasty. Results: Hips with FAI combined with decreased FV had a significantly ( P < .001) lower mean flexion (114°± 8° vs 125°± 13°) and internal rotation (IR) at 90° of flexion (18°± 6° vs 32°± 9°, P < .001) compared with the asymptomatic control group. Symptomatic patients with FAI and normal FV had flexion of 120°± 16° and IR at 90° of flexion of 23°± 15°. In a subgroup analysis, we found a significantly ( P < .001) lower IR in 90° of flexion in hips with FV less than 5° combined with mixed-type FAI compared with hips with FV less than 5° without a cam- or pincer-type deformity. The maximal acetabular impingement zone for hips with decreased FV was located at the 2-o’clock position and ranged from 1 to 3 o’clock. In hips with decreased FV, most of the impingement locations were intra-articular but 32% of hips had combined intra- and extra-articular FAI in internal rotation in 90° of flexion. During the flexion-adduction-IR test performed in 10° and 20° of adduction, extra-articular subspine FAI had significantly ( P < .001) higher prevalence (68% and 84%) in hips with decreased FV compared with normal hips. Conclusion: Hips with FAI and decreased FV had less flexion and internal rotation in 90° of flexion compared with the asymptomatic control group. The majority of hip impingement due to low FV was intra-articular, but one-third of samples had combined intra- and extra-articular subspine FAI. Anterior extra- and intra-articular hip impingement can be present in patients who have FAI with decreased FV. This could be important for patients undergoing hip arthroscopy.

Comparison of Shoulder Internal Rotation Test With the Elbow Flexion Test in the Diagnosis of Cubital Tunnel Syndrome

2011 ◽  
Vol 36 (5) ◽  
pp. 782-787 ◽  
Author(s):  
Kensuke Ochi ◽  
Yukio Horiuchi ◽  
Aya Tanabe ◽  
Kozo Morita ◽  
Kentaro Takeda ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Elbow Flexion ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Rotation Test ◽  
Tunnel Syndrome ◽  
Flexion Test

scholarly journals The Supine Internal Rotation Test

2015 ◽  
Vol 3 (2) ◽  
pp. 232596711557213 ◽  
Author(s):  
Samuel G. Moulton ◽  
Tyler R. Cram ◽  
Evan W. James ◽  
Grant J. Dornan ◽  
Nicholas I. Kennedy ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Rotation Test

scholarly journals Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures

2021 ◽  
Vol 2 (11) ◽  
pp. 988-996
Author(s):  
Maryam Mohtajeb ◽  
Jolanda Cibere ◽  
Michelle Mony ◽  
Honglin Zhang ◽  
Emily Sullivan ◽  
...  
Keyword(s):  
Femoral Head ◽  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Hip Osteoarthritis ◽  
Population Based ◽  
Joint Degeneration ◽  
Open Mri ◽  
Hip Flexion ◽  
Head Neck ◽  
Acetabular Rim

Aims Cam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-neck contour and acetabular rim in positions of hip flexion combined with rotation is a proposed pathomechanism in these hips, but this has not been studied in active postures. Our aim was to assess the anterior impingement pathomechanism in both active and passive postures with high hip flexion that are thought to provoke impingement. Methods We recruited nine participants with cam and/or pincer morphologies and with pain, 13 participants with cam and/or pincer morphologies and without pain, and 11 controls from a population-based cohort. We scanned hips in active squatting and passive sitting flexion, adduction, and internal rotation using open MRI and quantified anterior femoroacetabular clearance using the β angle. Results In squatting, we found significantly decreased anterior femoroacetabular clearance in painful hips with cam and/or pincer morphologies (mean -11.3° (SD 19.2°)) compared to pain-free hips with cam and/or pincer morphologies (mean 8.5° (SD 14.6°); p = 0.022) and controls (mean 18.6° (SD 8.5°); p < 0.001). In sitting flexion, adduction, and internal rotation, we found significantly decreased anterior clearance in both painful (mean -15.2° (SD 15.3°); p = 0.002) and painfree hips (mean -4.7° (SD 13°); p = 0.010) with cam and/pincer morphologies compared to the controls (mean 7.1° (SD 5.9°)). Conclusion Our results support the anterior femoroacetabular impingement pathomechanism in hips with cam and/or pincer morphologies and highlight the effect of posture on this pathomechanism. Cite this article: Bone Jt Open 2021;2(11):988–996.

Hip Internal Rotation Is Correlated to Radiographic Findings of Cam Femoroacetabular Impingement in Collegiate Football Players

2012 ◽  
Vol 28 (11) ◽  
pp. 1661-1670 ◽  
Author(s):  
Ashley L. Kapron ◽  
Andrew E. Anderson ◽  
Christopher L. Peters ◽  
Lee G. Phillips ◽  
Gregory J. Stoddard ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Football Players ◽  
Radiographic Findings ◽  
Hip Internal Rotation ◽  
Collegiate Football
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