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A painful squat test provides limited diagnostic utility in CAM-type femoroacetabular impingement

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to determine the relationship between a symptomatic maximal squat and the presence of radiographic CAM-type femoroacetabular impingement (FAI) on magnetic resonance imaging (MRI) and to determine the sensitivity and specificity of a maximal squat test for the presence of radiographic CAM-type femoral deformity in an adult population.

Methods

In this pilot study, 76 consecutive patients were recruited from an outpatient clinic at McMaster University. All patients presented with pre-arthritic hip pain and were asked to perform a maximal squat. The results of this test were compared to magnetic resonance imaging and magnetic resonance angiographic (MRI and MRA) findings evaluating and characterizing CAM-type FAI deformity.

Results

The sensitivity and specificity of the maximal squat test were 75 % (56.6–88.5 %) and 41 % (27.0–56.8 %), respectively, for CAM-type FAI deformity. The positive and negative likelihood ratios were modest at 1.3 (0.9–1.7) and 0.6 (0.3–1.2), respectively. This means that a 30 % pre-test probability is improved to 36 % following a positive squat test and reduced to 20 % with a negative squat test.

Conclusion

The maximal squat test was found to have marginal incremental diagnostic ability for CAM-type FAI. Its utility in the diagnostic evaluation of FAI remains limited. This survey elucidates areas of research for future studies relevant to the clinical diagnosis of FAI.

Level of evidence

III.

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Acknowledgments

We would like to thank Dr. Darren de SA, Orthopaedic Resident at McMaster University, for participating in photographs demonstrating the maximal squat test.

Conflict of interest

Dr. Bhandari is funded, in part, by a Canada Research Chair. The remaining authors do not declare any conflict of interest.

Author information

Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada

    Olufemi Ayeni, Raymond Chu, Bandar Hetaimish & Mohit Bhandari

  2. Orthopaedic Surgery Department, College of Medicine, Taibah University, Medina, Al Madina, Saudi Arabia

    Bandar Hetaimish

  3. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Liin Nur, Nicole Simunovic, Forough Farrokhyar & Mohit Bhandari

  4. MedSport, Department of Orthopaedic Surgery, University of Michigan, Lobby C, 24 Frank Lloyd Wright Dr., Ann Arbor, MI, 48106, USA

    Asheesh Bedi

  5. McMaster University Medical Centre, 1200 Main St West, 4E17, Hamilton, ON, L8N 3Z5, Canada

    Olufemi Ayeni

Authors
  1. Olufemi Ayeni
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  2. Raymond Chu
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  3. Bandar Hetaimish
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  4. Liin Nur
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  7. Asheesh Bedi
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  8. Mohit Bhandari
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Correspondence to Olufemi Ayeni.

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Ayeni, O., Chu, R., Hetaimish, B. et al. A painful squat test provides limited diagnostic utility in CAM-type femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 22, 806–811 (2014). https://doi.org/10.1007/s00167-013-2668-8

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  • DOI: https://doi.org/10.1007/s00167-013-2668-8

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