Clinical tests for diagnosing gluteal tendinopathy
The achievement of accurate musculoskeletal diagnosis at the hip can present a diagnostic enigma. This is due to the complexity of referring regions, as well as the state of validity of some common examination techniques. The authors of this study have advised on the use of clinical tests of the hip that are most useful in the examination of suspected gluteal tendinopathy (GT) confirmed by pathological MRI findings.
Lateral hip pain has accrued much attention in recent years, due to the ongoing challenges that occur with misinterpretations in findings. This has led to inaccurate diagnosis and incorrect management, most notably the underdiagnosis of GT. To date, evidence is conflicting and suggestive of clinical utility of some common tests however, none definitively associated with MRI findings of GT.
7 common clinical tests were identified and used for analysis in the examination for GT. Clustering of palpation with at least 1 other positive test was used for clinical diagnosis, and compared with MRI findings - as this was deemed most accurate for clinical utility. Tests found to have the both compressive and active tension components (SLS, modified FADER and ADD tests) were most specific and palpation was found most sensitive.
Although limitations exist, including methodological weakness, the authors advise that the use of both a highly sensitive and highly specific test, in combination with findings on MRI, yields the most accurate diagnosis of GT.
> From: Grimaldi et al., Br J Sports Med 51 (2017) 519-524. All rights reserved to BMJ Publishing Group Ltd. Click here for the online summary.