Objective

To investigate the diagnostic accuracy of patient history associated with hip pain.

Data Sources

A systematic, computerized search of electronic databases (PubMed, MEDLINE, Cumulative Index of Nursing and Allied Health Literature, and Web of Science), a search of the gray literature, and review of the primary author's personal library was performed. Hip-specific search terms were combined with diagnostic accuracy and subjective or self-report history-based search terms using the Boolean operator “AND.”

Study Selection

This systematic review was conducted and reported according to the protocol outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) patients with hip pain; (2) the statistical association of at least 1 patient history item was reported; (3) study designs appropriate for diagnostic accuracy; (4) adults aged ≥18 years; (5) written in English; and (6) used an acceptable reference standard for diagnosed hip pathology. Titles and abstracts of all database-captured citations were independently screened by at least 2 reviewers.

Data Extraction

Two reviewers independently extracted information and data regarding author, year, study population, study design, criterion standard, and strength of association statistics associated with the subjective findings.

Data Synthesis

For hip osteoarthritis (OA), a family history of OA (positive likelihood ratio [+LR], 2.13), history of knee OA (+LR, 2.06), report of groin or anterior thigh pain (+LR, 2.51-3.86), self-reported limitation in range of motion of 1 or both hips (+LR, 2.87), constant low back pain or buttock pain (+LR, 6.50), groin pain on the same side (+LR, 3.63), and a screening questionnaire (+LR, 3.87-13.29) were the most significant findings. For intra-articular hip pathology, crepitus (+LR, 3.56) was the most significant finding.

Conclusions

Patient history plays a key role in differential diagnosis of hip pain and in some cases can be superior to objective tests and measures.

中文翻译：

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髋关节相关疼痛诊断中患者病史的诊断准确性：系统评价

客观的

调查与髋部疼痛相关的患者病史的诊断准确性。

数据源

对电子数据库（PubMed、MEDLINE、护理和相关健康文献累积索引和科学网）进行了系统的计算机化搜索，对灰色文献进行了搜索，并对主要作者的个人图书馆进行了审查。使用布尔运算符“AND”将特定于臀部的搜索词与诊断准确性和基于主观或自我报告历史的搜索词相结合。

研究选择

该系统评价是根据系统评价和元分析的首选报告项目指南中概述的方案进行和报告的。纳入标准为：（1）髋部疼痛患者；(2) 报告了至少1个病史项目的统计关联；(3) 适合诊断准确性的研究设计；(4) ≥18岁的成年人；(5) 用英文书写；(6) 使用可接受的参考标准来诊断髋关节病理。所有数据库获取的引文的标题和摘要均由至少 2 名审稿人独立筛选。

数据提取

两名评价者独立提取了关于作者、年份、研究人群、研究设计、标准和与主观发现相关的关联统计强度的信息和数据。

数据综合

对于髋关节骨关节炎 (OA)，OA 家族史（阳性似然比 [+LR]，2.13），膝关节 OA 史（+LR，2.06），腹股沟或大腿前部疼痛报告（+LR，2.51-3.86） ，自我报告的一侧或双侧髋关节活动度受限（+LR，2.87），持续的腰痛或臀部疼痛（+LR，6.50），同侧腹股沟疼痛（+LR，3.63），以及筛查问卷 (+LR, 3.87-13.29) 是最重要的发现。对于关节内髋关节病理学，捻发音（+LR，3.56）是最重要的发现。

结论

患者病史在髋部疼痛的鉴别诊断中起着关键作用，并且在某些情况下可能优于客观测试和测量。