FABREX: A NEW CLINICAL TEST FOR DIAGNOSIS GLUTEAL TENDINOPATHY

This study aims to describe a simple and accurate semiological method executing a specific maneuver with the lower limb to direct the semiological investigation towards the tendinopathies in the gluteus medius and minimus.

Methods:

Fifty patients participated in the study, with a mean age of 44.1 ± 13 years, with persistent pain on the side of the hip for more than three months. To compare the FABREX (proposed test) and Lequesne semiological tests, in the diagnosis of tendinopathies in the gluteus medius and minimus, Magnetic Resonance Imaging (MRI) was adopted as the gold standard.

Results:

FABREX presented high sensitivity and moderate specificity for tendinopathy in the gluteus medius and high sensitivity and specificity for tendinopathy in the gluteus minimus.

Conclusion:

The proposed test, when positive, can be used to determine the diagnosis of gluteal tendinopathies (high specificity). Moreover, it has high sensitivity, excluding the diagnosis when negative. This study represents the initial step for validating the FABREX test, and can therefore be considered a simple and accurate procedure to identify patients with or without gluteal tendinopathies. Level of Evidence III, Case Control Study.

Keywords:
Hip; Gluteal Region; Tendinopathy

Age (years)
Average ± SD (minimum - maximum)	44.1 ± 13 (19 - 67)
Gender (n)
Male	8	16%
Female	42	84%
Injured Hip Side (n)
Right	25	50%
Left	25	50%
Lequesne Test (n)
Positive Lequesne	20	40%
Difficulty in achieving the Lequesne	27	54%
FABREX test (n)
Positive proposal	23	46%
Difficulty in conducting the proposed	2	4%
Pathologies of Great Trochanter Painful Syndrome (n)
Tendinopathy in the gluteus medius	14	28%
Tendinopathy in the gluteus minimus	26	52%
Trochanteric bursitis	17	34%
Trochanteric bursitis and tendinopathy in the gluteus minimus	3	6%
Trochanteric Bursitis and Tendinopathy in the gluteus medius and minimus	13	26%
Trochanteric bursitis	1	2%

Test/Result		Tendinopathy gluteus medius		Sens. (%)	Spec. (%)	PPV+ (%)	NPV- (%)	Accuracy (%)	Kappa
Test/Result		present	absent	Sens. (%)	Spec. (%)	PPV+ (%)	NPV- (%)	Accuracy (%)	value	*p-value*
LEQUESNE	pos	11	9	78.6	75	55	90	76	0.47	0.0005
LEQUESNE	neg	3	27	78.6	75	55	90	76	0.47	0.0005
Proposed PHASE 3	pos	12	11	85.7	69.4	52.2	92.6	74	0.46	0.0004
Proposed PHASE 3	neg	2	25	85.7	69.4	52.2	92.6	74	0.46	0.0004

Test/Result		Tendinopathy gluteus minimus		Sens. (%)	Spec. (%)	PPV+ (%)	NPV- (%)	Accuracy (%)	Kappa
Test/Result		present	absent	Sens. (%)	Spec. (%)	PPV+ (%)	NPV- (%)	Accuracy (%)	value	*p-value*
LEQUESNE	pos	17	3	65.4	87.5	85	70	76	0.52	0.0001
LEQUESNE	neg	9	21	65.4	87.5	85	70	76	0.52	0.0001
Proposed PHASE 3	pos	21	2	80.8	91.7	91.3	81.5	86.0	0.72	< 0.0001
Proposed PHASE 3	neg	5	22	80.8	91.7	91.3	81.5	86.0	0.72	< 0.0001

PROPOSED	LEQUESNE				Total
	with difficulty		without difficulty
	n	%	n	%
with difficulty	2	7.4	0	0	2
without difficulty	25	92.6	23	100	48
Total	27		23		50

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Fabrício Reichert Barin. Setor de Grandes Áreas Sul, Quadra 613, Conjunto C, Brasília, DF, Brazil, 70200730. fabriciobarin@gmail.com