Examination:
RISK FACTORS:
Clinicians should consider the presence of osseous abnormalities, local or global ligamentous laxity, connective tissue disorders, and nature of the patient’s activity and participation as risk factors for hip joint pathology. (Recommendation based on expert opinion.) DIAGNOSIS/CLASSIFICATION – NONARTHRITIC HIP JOINT PAIN: Clinicians should use the clinical findings of anterior groin or lateral hip pain or generalized hip joint pain that is reproduced with the hip flexion, adduction, internal rotation (FADIR) test, or the hip flexion, abduction, external rotation (FABER) test, along with consistent imaging findings, to classify a patient with hip pain into the International Statistical Classification of Diseases and Related Health Problems (ICD) categories of M25.5 Pain in joint, M24.7 Protrusio acetabula, M24.0 Loose body in joint, and M24.2 Disorder of ligament, and the associated International Classification of Functioning, Disability and Health (ICF) impairment-based categories of hip pain (b28016 Pain in joints) and mobility impairments (b7100 Mobility of a single joint; b7150 Stability of a single joint). (Recommendation based on weak evidence.) DIFFERENTIAL DIAGNOSIS: Clinicians should consider diagnostic categories other than non arthritic joint pain when the patient’s history, reported activity limitations, or impairments of body function and structure are not consistent with those presented in the Diagnosis / Classification section of this guideline or when the patient’s symptoms are not diminishing with interventions aimed at normalization of the impairments of body function. (Recommendation based on expert opinion.) EXAMINATION – OUTCOME MEASURES: Clinicians should use a validated outcome measure, such as the Hip Outcome Score (HOS), the Copenhagen Hip and Groin Outcome Score (HAGOS), or the International Hip Outcome Tool (iHOT- 33), before and after interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions in individuals with non arthritic hip joint pain. (Recommendation based on strong evidence.) EXAMINATION – PHYSICAL IMPAIRMENT MEASURES: When evaluating patients with suspected or confirmed hip pathology over an episode of care, clinicians should assess impairments of body function, including objective and reproducible measures of hip pain, mobility, muscle power, and movement coordination. (Recommendation based on moderate evidence). For more details: https://www.jospt.org/doi/pdf/10.2519/jospt.2014.0302
