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manuelletherapie 2014; 18(02): 81-91
DOI: 10.1055/s-0034-1376324
Originalia
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Erkennen klinischer Muster am Beispiel des femoroazetabulären Impingement-Syndroms

Eine Delphi-UntersuchungIdentifying Clinical Patterns Using the Example of the Femoroacetabular Impingement SyndromeA Delphi Study
Gerold Mohr
1   ZHAW – Zürcher Hochschule für angewandte Wissenschaften, CH-8401 Winterthur
,
Jacqueline Németh
1   ZHAW – Zürcher Hochschule für angewandte Wissenschaften, CH-8401 Winterthur
› Author Affiliations
Further Information

Publication History

30 August 2013

11 November 2013

Publication Date:
13 May 2014 (online)

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Zusammenfassung

In der physiotherapeutischen Praxis ist das Erkennen klinischer Muster ein wichtiger Bestandteil des klinischen Denkens und Handelns. Studien zum Thema Clinical Reasoning belegen, dass Experten mittels Mustererkennung ihr theoretisches Wissen und ihre klinische Erfahrung kombinieren, um Beschwerdebilder von Patienten einzuschätzen. Diese Fähigkeit ermöglicht Experten ein hohes Maß an Effizienz und Sicherheit bei der Untersuchung und Behandlung von Patienten.

Mithilfe einer Delphi-Untersuchung wurden die Beurteilungen von 11 Experten zum klinischen Muster des femoroazetabulären Impingements (FAI) ermittelt. In der aktuellen Literatur wurde außerdem nach klinischen Merkmalen des FAI und nach Reliabilität sowie Validität klinischer Tests zur Evaluation eines FAI gesucht.

Abstract

Identifying clinical patterns is an important component of the clinical reasoning and operational process in physiotherapeutic practice. Studies looking at clinical reasoning have shown, that experts combine their theoretical knowledge and their clinical experience to evaluate the patients’ clinical presentations using pattern recognition. This skill offers experts a high level of efficiency and reliability during assessment and treatment of patients.

11 expert evaluations regarding the clinical pattern of femoroacetabular impingement (FAI) were investigated using a delphi study. Furthermore, current literature was searched for clinical FAI signs as wells as the reliability and validity of clinical tests for the evaluation of FAI.

Schlüsselwörter

Mustererkennung - Clinical Reasoning - femoroazetabuläres - Impingement - Delphi-Untersuchung

Keywords

pattern recognition - clinical reasoning - femoroacetabular - impingement - Delphi study
 

  • Literatur

  • 1 Balch Samora J, Ng VY, Ellis TJ. Femoroacetabular impingement, a common cause of hip pain in young adults. Clin J Sport Med 2001; 21: 51-56
    PubMedGoogle Scholar
  • 2 Banerjee P, Mclean CR. Femoroacetabular impingement, a review of diagnosis and management. Curr Rev Muskuloskelet Med 2001; 4: 23-32
    PubMedGoogle Scholar
  • 3 Bossuyt PM, Reitsma JB, Bruns DE et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Standards for Reporting of Diagnostic Accuracy. Clin Chem 2003; 49: 1-6
    CrossrefPubMedGoogle Scholar
  • 4 Burnett RSJ, Della Rocca GJ, Prather H et al. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg 2006; 88A: 1448-1457
    PubMedGoogle Scholar
  • 5 Chan YS, Lien LC, Hsu HL et al. Evaluating hip labral tears using magnetic resonance arthrography: A prospective study comparing hip arthroscopy and magnetic resonance arthrography diagnosis. Arthroscopy 2005; 21: 1250
    PubMedGoogle Scholar
  • 6 Clohisy J, Knaus ER, Hunt DM et al. Clinical Presentation of Patients with Symptomatic Anterior Hip Impingement. Clin Orthop Relat Res 2009; 467: 638-644
    CrossrefPubMedGoogle Scholar
  • 7 Cook C, Brismée JM, Sizer PS. Subjective and objective descriptors of clinical lumbar spine instability: A delphi study. Manual Therapy 2006; 11: 11-21
    CrossrefPubMedGoogle Scholar
  • 8 Dooley PJ. Femoroacetabular impingement syndrome. Canadian Family Physician 2008; 4: 42-47
    PubMedGoogle Scholar
  • 9 Edwards I, Jones MA, Carr J et al. Clinical reasoning strategies in physical therapy. Physical Therapy 2004; 84: 312-330
    CrossrefPubMedGoogle Scholar
  • 10 Elstein AS, Schwarz A. Clinical problem solving and diagnostic decision making: selective review of the cognitive literature. BMJ 2002; 324: 729-732
    CrossrefPubMedGoogle Scholar
  • 11 Fitzgerald RH. Acetabular labrum tears. Clin Orthop 1995; 311: 60-68
    PubMedGoogle Scholar
  • 12 Ganz R, Gill T, Gautier E. Surgical dislocation oft the adult hip: a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br 2001; 83: 1119-1124
    CrossrefPubMedGoogle Scholar
  • 13 Ganz R, Parvizi J, Beck M et al. Femoroacetabular impingement: a cause of osteoarthritis of the hip. Clin Orthop Relat Res 2003; 417: 112-120
    PubMedGoogle Scholar
  • 14 Ganz R, Leunig M, Leunig-Ganz K et al. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 2008; 466: 264-272
    CrossrefPubMedGoogle Scholar
  • 15 Gautschi R. Manuelle Triggerpunkt-Therapie. Myofasziale Schmerzen und Funktionsstörungen erkennen, verstehen und behandeln. Stuttgart: Thieme; 2010
    CrossrefGoogle Scholar
  • 16 Häder M. Delphi-Befragungen – Ein Arbeitsbuch. Wiesbaden: VS Verlag für Sozialwissenschaften; 2009
    CrossrefGoogle Scholar
  • 17 Hart E, Mekar US, Rebello GN et al. Femoroacetabular impingement in adolescents and young adults. Orthopaedic Nursing 2009; 28: 117-124
    CrossrefPubMedGoogle Scholar
  • 18 Hartofilakidis G, Bardakos NV, Babis GC et al. An examination of the association between different morphotypes of FAI in asymptomatic subjects and the development of osteoarthritis of the hip. J Bone Joint Surg 2011; 93-B: 580-586
    CrossrefPubMedGoogle Scholar
  • 19 Hengeveld E, Banks K. Maitland’s Peripheral Manipulation. Edinburgh: Elsevier; 2005
    Google Scholar
  • 20 Horx M. Das Megatrend Prinzip – Wie die Welt von morgen entsteht. München: Deutsche Verlagsanstalt; 2011
    Google Scholar
  • 21 Howick J. Levels of Evidence. Produced by Bob Phillips, Chris Ball, Dave Sackett, Doug Badenoch, Sharon Straus, Brian Haynes, Martin Dawes since November 1998. Updated by Jeremy Howick March 2009. Oxford Centre for Evicence-Based Medicine (CEBM) 2009 www.cebm.net/index.aspx?o=1025 (20.07.2013)
    PubMedGoogle Scholar
  • 22 Ito K, Leunig M, Ganz R. Histopathologic features of the acetabular labrum in femoroacetabular impingement. Clin Orthop 2004; 429: 262-271
    CrossrefPubMedGoogle Scholar
  • 23 Jensen G, Resnik L, Haddad A. Expertise and clinical reasoning. In: Higgs J, Jones MA, Loftus S, et al. Clinical Reasoning in the Health Professions. New York: Butterworth-Heinemann; 2008
    Google Scholar
  • 24 Kappe T, Kocak T, Reichel H et al. Can femoroacetabular impingement and hip dysplasia be distinguished by clinical presentation and patient history?. Knee Surg Sports Traumatol Arthrosc 2011; 20: 387-392
    PubMedGoogle Scholar
  • 25 Kassarjian A, Belzile E. Femoroacetabular impingement: presentation, diagnosis and management. Seminars in Muskuloskeletal Radiology 2008; 12: 136-145
    PubMedGoogle Scholar
  • 26 Keogh MJ, Batt ME. A review of femoroacetabular impingement in athletes. Sports Med 2006; 38: 863-878
    PubMedGoogle Scholar
  • 27 Kuhlman GS, Domb BG. Hip impingement, identifying treating a common cause of hip pain. American Family Physician 2009; 80: 1429-1434
    PubMedGoogle Scholar
  • 28 Kusma M, Bachelier F, Schneider G et al. Femoroazetabuläres Impingement – klinische und radiologische Diagnostik. Orthopäde 2009; 38: 402-411
    CrossrefPubMedGoogle Scholar
  • 29 Lavigne M, Parvizi J, Beck M et al. FAI. Part I: Techniques of joint preserving surgery. Clin Orthop Relat Res 2004; 418: 61-66
    CrossrefPubMedGoogle Scholar
  • 30 Leibold M, Huijbregts PA, Jensen R. Concurrent criterion-related validity of physical examination tests for hip labral lesions. A systematic review. J Man Manip Ther 2008; 16: 24-41
    CrossrefPubMedGoogle Scholar
  • 31 Leunig M, Werlen S, Ungersböck A et al. Evaluation of the acetabular labrum by MR arthrography. J Bone Joint Surg 1997; 79B: 230-234
    PubMedGoogle Scholar
  • 32 Leunig M, Casillas MM, Hamlet M et al. Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysic. Acta Orthop Scand 2000; 71: 370-375
    CrossrefPubMedGoogle Scholar
  • 33 Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. The Journal of Orthopaedic and Sports Physical Therapy 2008; 38: 71-77
    CrossrefPubMedGoogle Scholar
  • 34 Martin RL, Kelly BT, Leunig M et al. Reliability of clinical diagnosis in intraarticular hip diseases. Knee Surg Sports Traumatol Arthrosc 2010; 18: 685-690
    CrossrefPubMedGoogle Scholar
  • 35 Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res 1999; 363: 93-99
    PubMedGoogle Scholar
  • 36 Narvani A, Tsiridis E, Kendall S et al. A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain. Knee Surg Sports Traumatol Arthroscop 2003; 11: 403-408
    PubMedGoogle Scholar
  • 37 Petersilge CA, Haque MA, Petersilge WJ et al. Acetabular labral tears: Evaluation with MR arthrography. Radiology 1996; 200: 231-235
    CrossrefPubMedGoogle Scholar
  • 38 Pfund R, Zahnd F. Leitsymptom Schmerz. Differenzierende manualtherapeutische Untersuchung und Therapie bei Bewegungsstörungen. Bd. 2. Stuttgart: Thieme; 2003
    CrossrefGoogle Scholar
  • 39 Philippon MJ, Maxwell RB, Johnston TL et al. Clinical presentation of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 2007; 15: 1041-1047
    CrossrefPubMedGoogle Scholar
  • 40 Reid GD, Reid CG, Widmer N et al. Femoroacetabular Impingement Syndrome, an unrecognized cause of hip pain and premature osteoarthritis. J Rheumatol 2010; 37: 1395-1404
    CrossrefPubMedGoogle Scholar
  • 41 Sahrmann S. Movement Impairment Syndromes. St. Louis: Mosby; 2002
    Google Scholar
  • 42 Siebenrock KA, Henle P. X-Ray Examination in FAI. In: Marin-Pena O. (ed) Femoroacetabular Impingement. Heidelberg: Springer; 2012
    CrossrefGoogle Scholar
  • 43 Sink EL, Gralla J, Ryba A et al. Clinical presentation of femoroacetabular impingement in adolescents. J Pediatr Orthop 2010; 28: 806-811
    PubMedGoogle Scholar
  • 44 Smart KM, Blake C, Staines A et al. Clincal indicators of “nociceptive”, “peripheral neuropathic” and “central” mechanisms of musculoskeletal pain. A Delphi survey of expert clinicians. Manual Therapy 2010; 15: 80-87
    CrossrefPubMedGoogle Scholar
  • 45 Stafford G, Witt J. The anatomy, diagnosis and pathology of femoroacetabular impingement. British Journal of Hospital Medicine 2009; 70: 72-77
    CrossrefPubMedGoogle Scholar
  • 46 Whiting P, Rutjes AWS, Reitsma JB et al. The developement of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 2003; 3: 1-13
    CrossrefPubMedGoogle Scholar