Ageberg, E

Agricola, R

Bizzini, M

Bloom, N

Casartelli, NC

Crossley, KM

Di Stasi, S

Diamond, LE

Dijkstra, HP

Drew, M

Freke, M

Friedman, DJ

Glyn-Jones, S

Gojanovic, B

Griffin, D

Harris-Hayes, M

Heerey, JJ

Hunt, MA

Hölmich, P

Impellizzeri, FM

Ishøi, L

Jones, DM

Kassarjian, A

Kemp, JL

Khan, KM

King, MG

Lawrenson, PR

Leunig, M

Lewis, CL

Mathieu, N

Mayes, S

Moksnes, H

Mosler, AB

Reiman, MP

Risberg, MA

Scholes, MJ

Semciw, AI

Serner, A

Thorborg, K

van Klij, P

Virgile, A

Warholm, KM

Weir, A

Wörner, T

Reiman, Michael P

Agricola, Rintje

Kemp, Joanne L

Heerey, Joshua J

Weir, Adam

van Klij, Pim

Kassarjian, Ara

Mosler, Andrea B

Ageberg, Eva

Hölmich, Per

Warholm, Kristian Marstrand

Griffin, Damian

Mayes, Sue

Khan, Karim M

Crossley, Kay M

Bizzini, Mario

Bloom, Nancy

Casartelli, Nicola C

Diamond, Laura E

Di Stasi, Stephanie

Drew, Michael

Friedman, Daniel J

Freke, Matthew

Glyn-Jones, Sion

Gojanovic, Boris

Harris-Hayes, Marcie

Hunt, Michael A

Impellizzeri, Franco M

Ishøi, Lasse

Jones, Denise M

King, Matthew G

Lawrenson, Peter R

Leunig, Michael

Lewis, Cara L

Mathieu, Nicolas

Moksnes, Håvard

Risberg, May Arna

Scholes, Mark J

Semciw, Adam I

Serner, Andreas

Thorborg, Kristian

Virgile, Adam

Wörner, Tobias

Dijkstra, H Paul

Oxford University Research Archive

   1Reiman MP, et al. Br J Sports Med Month 2020 Vol 0 No 0Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip- related pain in young and middle- aged active adults from the International Hip- related Pain Research Network, Zurich 2018Michael P Reiman   ,1 Rintje Agricola   ,2 Joanne L Kemp   ,3 Joshua J Heerey   ,3 Adam Weir,4,5 Pim van Klij   ,6 Ara Kassarjian   ,7,8 Andrea B Mosler   ,3 Eva Ageberg   ,9 Per Hölmich,10 Kristian Marstrand Warholm   ,11 Damian Griffin,12,13 Sue Mayes,3 Karim M Khan   ,14 Kay M Crossley   ,3 Mario Bizzini,15 Nancy Bloom,16 Nicola C Casartelli   ,17,18 Laura E Diamond   ,19,20 Stephanie Di Stasi,21 Michael Drew,22,23 Daniel J Friedman,24 Matthew Freke,25 Sion Glyn- Jones,26 Boris Gojanovic   ,27,28 Marcie Harris- Hayes   ,16 Michael A Hunt,29 Franco M Impellizzeri   ,30 Lasse Ishøi   ,31 Denise M Jones,3 Matthew G King   ,32 Peter R Lawrenson   ,33 Michael Leunig,34 Cara L Lewis   ,35 Nicolas Mathieu,36 Håvard Moksnes,37 May Arna Risberg,38,39 Mark J Scholes   ,40 Adam I Semciw   ,3 Andreas Serner   ,41 Kristian Thorborg   ,10 Adam Virgile   ,42 Tobias Wörner   ,9 H Paul Dijkstra   43,44InfographicYoung and middle- aged active adults with hip and groin pain often present with a confusing overlap of signs and symptoms. There is no consensus on how to define or classify hip disease with different and over-lapping intra- articular and extra- articular contributors to symptoms in an anatomi-cally complex region. Several researchers and consensus groups have previously attempted to define aspects of hip and groin pain.1–4 In 2017, the International Hip Pain Research Network (IHiPRN) was established to facilitate collaboration across research groups and disciplines and to improve knowledge dissemination of hip- related pain to clinicians. In this paper,5 published in the British Journal of Sports Medicine, we first describe the general consensus process applied to all topics in this series. We then make recom-mendations on the first topic on how to classify, define and diagnose hip disease in young and middle- aged active adults, with hip- related pain as the main symptom. Other papers in this series used this clas-sification of hip- related pain in the assess-ment of (1) patient- reported outcome Oxford. Protected by copyright. on November 4, 2020 at Bodleian Libraries of the University ofhttp://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2020-102219 on 31 August 2020. Downloaded from 2 Reiman MP, et al. Br J Sports Med Month 2020 Vol 0 No 0Infographicmeasures,6 (2) standardised measurement of physical capacity7 and (3) physiothera-pist- led treatment.8For this paper, the working group used a scoping review framework to search the literature for systematic reviews, interven-tion and observational studies (prospective or retrospective) with a study population of at least 10 young and middle- aged active adults and published in English language, peer- reviewed journals. Evidence summa-ries and consensus recommendations were then presented to and discussed by the whole group of IHiPRN partic-ipants. We reached consensus on three clinical recommendations, one clinical and research recommendation, and two research recommendations (infographic), all of which were an amalgamation of best available evidence and expert opinion. Following discussion, each participant was asked to perform a blinded vote on the recommendation (infographic). Both non- musculoskeletal and serious hip pathology conditions (eg, tumours, infections, slipped capital femoral epiphysis), as well as competing musculoskeletal conditions (eg, lumbar spine) should first be excluded before categorising hip disease in young and middle- aged active adults presenting with hip- related pain. Once these are excluded, hip- related pain should be cate-gorised into (1) femoroacetabular impinge-ment syndrome, (2) acetabular dysplasia and/or hip instability and (3) other condi-tions without bony morphology causing hip- related pain, such as chondral, labral and ligamentum teres conditions.The diagnostic clinical utility for the various clinical and radiological measures was stratified according to magnitude of the pretest to post- test probability shift, precision (repeatability of the results), and study quality. Each of these values were represented on a 2×2 quadrant (magni-tude×precision) as not recommended (red quadrant), cautiously recommended (yellow quadrants) or recommended (green quadrant) if the study quality was high.We determined that the diagnostic utility of clinical examination and diag-nostic imaging in isolation are limited and recommend a comprehensive diagnostic approach of patient symptoms, clinical signs and diagnostic imaging. We recognise that the diagnostic capability of matching symptoms, clinical signs and diagnostic imaging is unknown for patients with hip- related pain and recommend that future studies be considered in determining such diagnostic utilities.1Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA2Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands3Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia4Department of Orthopaedic Surgery, Erasmus MC Center for Groin Injuries, Erasmus University Medical Centre, Rotterdam, Netherlands5Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar6Department of Orthopaedic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands7Elite Sports Imaging, SL, Madrid, Spain8Musculoskeletal Radiology, Corades, LLC, Brookline, Massachusetts, USA9Health Sciences, Lund University, Lund, Sweden10Sports Orthopaedic Research Center–Copenhagen (SORC- C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager- Hvidovre, Denmark, Amager- Hvidovre Hospital, Hvidovre, Copenhagen, Denmark11Division of Orthopeadic surgery, Oslo University Hospital, Oslo, Norway12Warwick Orthopaedics, University of Warwick, Coventry, UK13Orthopaedics Warwick Medical School, University of Warwick, Coventry, UK14Family Practice & Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada15Research, Schulthess Clinic Human Performance Lab, Zurich, ZH, Switzerland16Physical Therapy, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA17Human Performance Lab, Schulthess Clinic, Zurich, Switzerland18Laboratory of Exercise and Health, ETH Zurich, Schwerzenbach, Switzerland19School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia20Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia21Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA22Department of Physiotherapy, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia23Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia24Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia25School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia26Department of Orthopaedic Surgery, University of Oxford, Institute of Musculoskeletal Sciences, Oxford, UK27Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Geneva, Switzerland28Sports Medicine, University Hospital of Lausanne, Lausanne, VD, Switzerland29Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada30Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia31Department of Orthopedic Surgery, Copenhagen University Hospital, Amager- Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC- C), Hvidovre, Denmark32La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services, and Sport, La Trobe University, Bundoora, Victoria, Australia33School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia34Department of Orthopaedics, Schulthess Klinik, Zurich, Switzerland35Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA36Physiotherapy, HES- SO Valais, University of Applied Sciences Western Switzerland, Leukerbad, Valais, Switzerland37Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway38Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway39Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway40La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia41Research & Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar42College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA43Sports Medicine, ASPETAR Orthopedic and Sports Medicine Hospital, Doha, Qatar44Department for Continuing Education, University of Oxford, Oxford, UKCorrespondence to Rintje Agricola, Department of Orthopaedic Surgery, Erasmus University Medical Center, 3015 GD Rotterdam, Netherlands;   r. agricola@ erasmusmc. nlTwitter Michael P Reiman @MikeReiman, Rintje Agricola @RintjeAgricola, Joanne L Kemp @JoanneLKemp, Joshua J Heerey @JHeerey, Pim van Klij @pimvklij, Andrea B Mosler @AndreaBMosler, Eva Ageberg @EvaAgeberg, Damian Griffin @DamianGriffin, Nicola C Casartelli @NicCasartelli, Laura E Diamond @lauradiamond05, Michael Drew @_mickdrew, Daniel J Friedman @ddfriedman, Boris Gojanovic @drsportsante, Marcie Harris- Hayes @MHarrisHayes, Franco M Impellizzeri @francoimpell, Lasse Ishøi @LasseIshoei, Matthew G King @mattgmking1, Peter R Lawrenson @PeteLawrenson, Cara L Lewis @ProfCaraLewis, Håvard Moksnes @HMoksnes, Mark J Scholes @MarkScholes85, Adam I Semciw @ASemciw, Andreas Serner @aserner, Kristian Thorborg @KThorborg, Adam Virgile @adamvirgile, Tobias Wörner @Wuninho and H Paul Dijkstra @DrPaulDijkstraContributors AV, RA, MPR and HPD contributed to the conception of the work. All authors contributed to the interpretation, drafting and revision of the infographic and gave their final approval.Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not- for- profit sectors.Competing interests None declared.Patient consent for publication Not required.Provenance and peer review Not commissioned; externally peer reviewed.Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non- commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.© Author(s) (or their employer(s)) 2020. Re- use permitted under CC BY- NC. No commercial re- use. See rights and permissions. Published by BMJ.Oxford. Protected by copyright. on November 4, 2020 at Bodleian Libraries of the University ofhttp://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2020-102219 on 31 August 2020. Downloaded from 3Reiman MP, et al. Br J Sports Med Month 2020 Vol 0 No 0InfographicTo cite Reiman MP, Agricola R, Kemp JL, et al. Br J Sports Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/bjsports-2020-102219Accepted 27 July 2020Br J Sports Med 2020;0:1–3.doi:10.1136/bjsports-2020-102219ORCID iDsMichael P Reiman http:// orcid. org/ 0000- 0003- 4557- 3446Rintje Agricola http:// orcid. org/ 0000- 0002- 0645- 093XJoanne L Kemp http:// orcid. org/ 0000- 0002- 9234- 1923Joshua J Heerey http:// orcid. org/ 0000- 0001- 8691- 1830Pim van Klij http:// orcid. org/ 0000- 0002- 6515- 8322Ara Kassarjian http:// orcid. org/ 0000- 0002- 9969- 3227Andrea B Mosler http:// orcid. org/ 0000- 0001- 7353- 2583Eva Ageberg http:// orcid. org/ 0000- 0002- 8639- 3006Kristian Marstrand Warholm http:// orcid. org/ 0000- 0003- 0978- 0667Karim M Khan http:// orcid. org/ 0000- 0002- 9976- 0258Kay M Crossley http:// orcid. org/ 0000- 0001- 5892- 129XNicola C Casartelli http:// orcid. org/ 0000- 0002- 1280- 866XLaura E Diamond http:// orcid. org/ 0000- 0002- 2197- 1856Boris Gojanovic http:// orcid. org/ 0000- 0001- 5075- 9371Marcie Harris- Hayes http:// orcid. org/ 0000- 0003- 4274- 1651Franco M Impellizzeri http:// orcid. org/ 0000- 0002- 1703- 2573Lasse Ishøi http:// orcid. org/ 0000- 0002- 2716- 6567Matthew G King http:// orcid. org/ 0000- 0003- 0470- 5924Peter R Lawrenson http:// orcid. org/ 0000- 0002- 6479- 6840Cara L Lewis http:// orcid. org/ 0000- 0002- 9888- 4902Mark J Scholes http:// orcid. org/ 0000- 0001- 9216- 1597Adam I Semciw http:// orcid. org/ 0000- 0001- 5399- 7463Andreas Serner http:// orcid. org/ 0000- 0003- 4308- 901XKristian Thorborg http:// orcid. org/ 0000- 0001- 9102- 4515Adam Virgile http:// orcid. org/ 0000- 0003- 2146- 7964Tobias Wörner http:// orcid. org/ 0000- 0001- 5555- 0876H Paul Dijkstra http:// orcid. org/ 0000- 0003- 3166- 1357REFERENCES 1 Weir A, Brukner P, Delahunt E, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med 2015;49:768–74. 2 Griffin DR, Dickenson EJ, O’Donnell J, et al. The Warwick agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 2016;50:1169–76. 3 Nepple JJ, Prather H, Trousdale RT, et al. Clinical diagnosis of femoroacetabular impingement. J Am Acad Orthop Surg 2013;21:S16–19. 4 Reiman MP, Thorborg K, Covington K, et al. Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome: an international and multi- disciplinary Delphi survey. Knee Surg Sports Traumatol Arthrosc 2017;25:1975–86. 5 Reiman MP, Agricola R, Kemp JL, et al. Consensus recommendations on the classification, definition and diagnostic criteria of hip- related pain in young and middle- aged active adults from the International Hip- related pain research network, Zurich 2018. Br J Sports Med 2020. 6 Impellizzeri FM, Jones DM, Griffin D, et al. Patient- Reported outcome measures for hip- related pain: a review of the available evidence and a consesnsus statement from the International Hip- related pain research network (IHiPRN) meeting, Zurich, 2018. Br J Sports Med 2020. 7 Mosler AB, Kemp J, King M, et al. Standardised measurement of physical capacity in young and middle- aged active adults with hip- related pain: recommendations from the first international Hip- related pain research network (IHiPRN) meeting, Zurich, 2018. Br J Sports Med 2019. 8 Kemp JL, Risberg MA, Mosler A, et al. Physiotherapist- led treatment for young to middle- aged active adults with hip- related pain: consensus recommendations from the International Hip- related pain research network, Zurich 2018. Br J Sports Med 2019.Oxford. Protected by copyright. on November 4, 2020 at Bodleian Libraries of the University ofhttp://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2020-102219 on 31 August 2020. Downloaded from 

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Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018

Infographic. Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018

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