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The identification of clinically relevant indicators to support diagnostic recognition of adult hip dysplasia

Evans, Elizabeth ORCID: 2022. The identification of clinically relevant indicators to support diagnostic recognition of adult hip dysplasia. PhD Thesis, Cardiff university.
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Acetabular hip dysplasia (AHD) is a treatable condition. Early referral for X-Ray evaluation and specialist treatment are pivotal for successful management. AHD is however, poorly recognised by clinicians including physiotherapists, and patients have been shown to wait unacceptable time periods before their AHD diagnosis is recognised. This delay is coupled with prolonged suffering of pain and increased severity of secondary osteoarthritis, which results in poor surgical outcomes. An important role of first contact and musculoskeletal physiotherapists is management of patients with hip problems. The aim of this thesis was to identify clinically relevant indicators that would support diagnostic suspicion of AHD by these physiotherapists and accelerate appropriate referral. The study comprised three pillars of investigation. Pillars 1 and 2 extend the understanding of AHD presentation through questionnaire surveys, which were used to collect the features of AHD experienced by those living with the condition (Pillar 1) and by those experienced in the relevant surgical correction (Pillar 2). Pillar 3 was an observational study that recorded the approach of musculoskeletal physiotherapists to the assessment of patients with hip problems. This identified whether opportunities were available for the identification of patients in whom AHD should be suspected. The findings established that during patient assessment, physiotherapists successfully elicit information relevant to increasing the index of suspicion for AHD presence, but they do not recognise the relevance of that information nor the requirement for X-Ray referral. This indicates that the opportunity exists to inform practice and to apply new knowledge of AHD presentation. In conclusion, this study offers extended understanding of potential AHD indicators as described by people living with the condition and those with expertise in its surgical correction. This knowledge should support diagnostic suspicion of AHD, and possibly accelerate referral for X-Ray evaluation and definitive diagnosis when appropriate.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Healthcare Sciences
Date of First Compliant Deposit: 15 December 2022
Last Modified: 22 Jun 2023 15:46

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