Diagnostic accuracy of patient history in the diagnosis of hip-related pain: a systematic review

Key Points

1. The patient interview plays a key role in the differential diagnosis of hip joint related pain.

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BACKGROUND & OBJECTIVE

Patients with hip pain commonly present to health professionals for examination and management of various underlying conditions. The assessment process usually involves a detailed patient interview, followed by a physical examination. Clinimetric studies have reported that physical tests have limited usefulness in predicting the presence of intra-articular hip pathology or femoroacetabular impingement (FAI), and are generally more useful for excluding hip joint conditions (1).

In making medical diagnoses, there is some evidence to suggest the subjective examination or medical history leads to most diagnoses, with physical examination or laboratory tests most useful for ruling out potential diagnoses (2). With the increase in telehealth assessments subsequent to the coronavirus pandemic, an investigation of the usefulness of the patient interview in differential diagnoses of musculoskeletal conditions is warranted. This systematic review aimed to investigate the diagnostic accuracy of patient history associated with hip pain.

Physical tests have limited usefulness in predicting the presence of (ruling in) intra-articular hip pathology or femoroacetabular impingement.

For hip pain, the patient interview may be most useful for ruling in joint pathology, with the physical examination useful for excluding joint pathology.

METHODS

A systematic review of studies that examined the diagnostic utility of patient history in the assessment of people with hip-related pain was performed. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were only

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