Can standardised clinical examination of athletes with acute groin injuries predict the presence and location of MRI findings?

Serner A, Weir A, Tol JL, Thorborg K, Roemer F, Guermazi A, Holmich P (2016)

Publication Type: Journal article

Publication year: 2016

Journal

British Journal of Sports Medicine BMJ Publishing Group

Book Volume: 50

Pages Range: 1541-1547

Journal Issue: 24

DOI: 10.1136/bjsports-2016-096290

Abstract

Little is known about the value of clinical examination in relation to diagnostic imaging for acute groin injuries in athletes. Primary aim: to investigate whether clinical examination tests predict a positive or negative MRI result (MRI±). Secondary aim: to assess accuracy of clinical tests to localise injury in MRI+ cases.We consecutively included 81 male athletes with acute groin injuries. Standardised clinical examination (palpation, resistance and stretch tests) and MRI were performed within 7 days of injury. Diagnostic statistics including positive and negative predictive values (PPV/NPV) were calculated.85 acute injuries were found on MRI in 64 (79%) athletes with 17 (21%) athletes having MRI- injuries. Palpation had the highest NPV (91-96%, (95% CI 69% to 99%)). 3 specific adductor examination tests (resisted outer range adduction, squeeze test with hip neutral and long lever, and passive adductor stretch) showed 80-81% (95% CI 63% to 91%) probability of an MRI+ adductor lesion when positive, all with high accuracy of a correct MRI location (PPV 93-97% (95% CI 76% to 100%)). Hip flexor tests showed poor ability to predict MRI+ lesions (PPV 34-63% (95% CI 20% to 84%)) and low accuracy (PPV 17-71% (95% CI 7% to 85%)).21% of athletes had negative imaging and the absence of palpation pain was best at predicting an MRI- result. Specific adductor examination tests accurately predicted MRI+ adductor injuries. Hip flexor clinical tests were poor at predicating and localising MRI+ injuries in the hip flexors. Clinical examination appears sufficient to diagnose acute adductor injuries, whereas MRI could assist in accurately locating acute hip flexor injuries.

Authors with CRIS profile

Frank Roemer Institute of Radiology

Involved external institutions

Aspetar - Orthopaedic and Sports Medicine Hospital /سبيتار QA Qatar (QA) Copenhagen University Hospital DK Denmark (DK) Boston University US United States (USA) (US)

How to cite

APA:

Serner, A., Weir, A., Tol, J.L., Thorborg, K., Roemer, F., Guermazi, A., & Holmich, P. (2016). Can standardised clinical examination of athletes with acute groin injuries predict the presence and location of MRI findings? British Journal of Sports Medicine, 50(24), 1541-1547. https://doi.org/10.1136/bjsports-2016-096290

MLA:

Serner, Andreas, et al. "Can standardised clinical examination of athletes with acute groin injuries predict the presence and location of MRI findings?" British Journal of Sports Medicine 50.24 (2016): 1541-1547.

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