Format

Send to

Choose Destination
Arthroscopy. 2018 Jan;34(1):114-121. doi: 10.1016/j.arthro.2017.06.048. Epub 2017 Dec 6.

Accuracy of 3 Clinical Tests to Diagnose Proximal Hamstrings Tears With and Without Sciatic Nerve Involvement in Patients With Posterior Hip Pain.

Author information

1
Department of Physical Therapy, Duquesne University, Pittsburg, Pennsylvania, U.S.A.; UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, U.S.A.
2
Hip Preservation Center, Baylor Scott&White Health System, Dallas, Texas, U.S.A.
3
Orthopedic Unit, Clínica Las Américas, Medellín, Colombia; GRINMADE Research Group, Universidad de Antioquia, Medellín, Colombia.
4
Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, U.S.A.
5
Hip Preservation Center, Baylor Scott&White Health System, Dallas, Texas, U.S.A.. Electronic address: haldavidmartin@yahoo.com.

Abstract

PURPOSE:

To determine the diagnostic accuracy of the active hamstring test at 30° (A-30) and 90° (A-90) of knee flexion, the long stride heel strike (LSHS) test, and combination of the 3 tests for individuals with hamstring tendon tears, with and without sciatic nerve involvement.

METHODS:

A retrospective review of 564 consecutive clinical records identified 42 subjects with a mean age of 50.31 ± 15 years who underwent a standard physical examination prior to magnetic resonance imaging (MRI) evaluation and diagnostic injection for posterior hip. The physical examination included the A-30, A-90, and LSHS tests. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated to determine the diagnostic accuracy of these 3 tests.

RESULTS:

Forty-two subjects (female = 32 and male = 10) with a mean age of 50.31 years (range 15-77, ± SD 14.52) met the inclusion criteria and were included in the review. Based on MRI and/or injection, 64.28% (27/42) of subjects were diagnosed with hamstring tear. Fourteen (51.85%) presented with sciatic nerve involvement. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each test were as follows: A-30 knee flexion: 0.73, 0.97, 23.43, 0.28, and 84.73; A-90 knee flexion: 0.62, 0.97, 20.00, 0.39, and 51.67; LSHS: 0.55, 0.73, 2.08, 0.61, and 3.44. The most accurate findings were obtained when the results of the A-30 and A-90 were combined, with sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of 0.84, 0.97, 26.86, 0.17, and 161.89, respectively.

CONCLUSION:

The combination of the active hamstring A-30 and A-90 tests proved to be a highly accurate and valuable tool to diagnose proximal hamstring tendons tears with or without sciatic nerve involvement in subjects presenting with posterior hip pain.

LEVEL OF EVIDENCE:

Level III, diagnostic study.

PMID:
29203381
DOI:
10.1016/j.arthro.2017.06.048
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center