Validität klinischer Tests zur Bestimmung des Antetorsionswinkels des Femurs

Zusammenfassung

Die Diagnosestellung des femoroazetabulären Impingements (FAI) beruht auf morphologischen Veränderungen des Hüftkopfes und/oder der Hüftpfanne, die in bildgebenden Verfahren festgestellt werden. Eine dieser Veränderungen ist eine abnormale Antetorsion des Femurs. Diese wird in der Literatur zudem als beitragender Faktor zur Entstehung des FAI und der Osteoarthrose, sondern auch von Low Back Pain und Knieschmerzen diskutiert.

Eine der großen Herausforderungen für Physiotherapeuten liegt darin, möglichst alle beitragenden Faktoren zu identifizieren, die die Entstehung eines FAI oder einer Osteoarthrose begünstigen oder beschleunigen könnten und die Behandlung entsprechend anzupassen.

Die vorliegende Arbeit versuchte einerseits herauszufinden, welche klinischen Tests zur Ermittlung der Antetorsion des Femurs in der Literatur beschrieben sind und andererseits die klinische Präsentation einer veränderten Antetorsion des Femurs darzustellen.

Der Craig’s Test (Trochanteric Prominence Angle Test, Ruwe’s Test) und die Hüftinnenrotation weisen auf eine klinisch relevante Validität und Reliabilität hin. Es wird empfohlen, mehrere Tests zu kombinieren.

Abstract

The diagnosis of femoroacetabular impingement (FAI) is based on morphologic changes of the femoral head and/or femoral socket which are determined using medical imaging. One of these changes is an abnormal femoral antetorsion. This has also been discussed in the literature as not only being a contributing factor to the development of FAI and osteoarthrosis, but also to low back pain and knee pain.

One major challenge for physiotherapists is the identification of all contributing factors which may promote or accelerate the development FAI or osteoarthrosis and to adjust interventions accordingly.

This paper attempted, on the one hand, to identify clinical tests for the assessment of femoral antetorsion which have been described in literature and, on the other hand, to portray the clinical presentation of femoral antetorsion.

Craig’s test (trochanteric prominence angle test, Ruwe’s test) and internal hip rotation show a clinically relevant validity and reliability. It is recommended to combine several tests.

Schlüsselwörter

femorale Antetorsion - körperliche Untersuchung - klinisches Erscheinungsbild - Sensitivität - Spezifität - Reliabilität

Keywords

femoral antetorsion - physical examination - clinical presentation - sensitivity - specificity - reliability

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