EP7.13 Diagnosis of iliopsoas-related groin pain and interrater reliability of the Hip Externoflexion Ceiling (HEC) test: a combined systematic review and reliability study

Clicks: 10
ID: 331249
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #313 of 444 articles by views in Journal of hip preservation surgery

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 444 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Iliopsoas-related groin pain is a clinically relevant but diagnostically challenging condition due to symptom overlap with other hip pathologies and limited utility of imaging. Reliable and accurate clinical tests are essential for clinical decision-making. The Hip Externoflexion Ceiling (HEC) test has recently been proposed as a promising diagnostic tool, but evidence on its interrater reliability remains limited. Objectives This combined systematic review and reliability study aims to evaluate (1) the diagnostic accuracy of clinical tests for iliopsoas-related groin pain, and (2) the interrater reliability of the HEC test within a standardized clinical examination protocol. Methods A systematic review was conducted according to PRISMA 2020 guidelines (PROSPERO registered). Studies assessing diagnostic accuracy of clinical tests for iliopsoas-related groin pain were included. Risk of bias was assessed using QUADAS-3, and a narrative synthesis was performed. Additionally, a cross-sectional interrater reliability study was conducted in individuals following total hip arthroplasty. Two independent raters assessed patients using a standardized clinical test protocol. Interrater reliability of the HEC test was evaluated using weighted Cohen’s kappa. Results Three diagnostic accuracy studies were included. Overall, evidence for clinical tests was limited. The HEC test demonstrated the highest diagnostic accuracy, with reported sensitivity of 94% and specificity of 88% when compared to diagnostic injection. Other commonly used tests (e.g. resisted hip flexion, straight leg raise in external rotation) showed high sensitivity but poor specificity, limiting their standalone diagnostic value. In the reliability study (n = 90; 95 hips), the HEC test demonstrated substantial interrater reliability (κ = 0.72), outperforming many other extra-articular hip tests. In contrast, adductor- and rectus femoris-related tests showed only fair to moderate agreement (κ = 0.20–0.41), and hamstring tests were inconsistent (κ = 0.17–0.62), likely influenced by skewed distributions with predominantly low scores. Conclusion The HEC test appears to be a promising clinical tool for the assessment of iliopsoas-related groin pain, combining high diagnostic accuracy with substantial interrater reliability. However, current evidence remains limited and heterogeneous. Clinical assessment should not rely on a single test, and further high-quality diagnostic studies are needed to support evidence-based diagnostic pathways.
Reference Key
openalex_W7220424471 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Abner Sergooris, Stijn Roose, Kristoff Corten, Frans-Jozef Vandeputte
Are you one of these authors? Claim your profile
Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.376
URL
https://doi.org/10.1093/jhps/hnag043.376
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.