Diagnosing painful sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests
| Autor: | Mark Laslett, Charles Aprill, Barry McDonald, Sharon B. Young |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Provocation test Physical examination Physical Therapy Sports Therapy and Rehabilitation Likelihood ratios in diagnostic testing Sensitivity and Specificity Sacroiliac joint dysfunction Predictive Value of Tests Medicine Humans Physical Examination Pelvis Physical Therapy Modalities Aged Sacroiliac joint medicine.diagnostic_test business.industry Reproducibility of Results Sacroiliac Joint Middle Aged musculoskeletal system Arthralgia Clinical trial Radiography medicine.anatomical_structure Predictive value of tests Physical therapy Female medicine.symptom business |
| Zdroj: | The Australian journal of physiotherapy. 49(2) |
| ISSN: | 0004-9514 |
| Popis: | Research suggests that clinical examination of the lumbar spine and pelvis is unable to predict the results of diagnostic injections used as reference standards. The purpose of this study was to assess the diagnostic accuracy of a clinical examination in identifying symptomatic and asymptomatic sacroiliac joints using double diagnostic injections as the reference standard. In a blinded concurrent criterion-related validity design study, 48 patients with chronic lumbopelvic pain referred for diagnostic spinal injection procedures were examined using a specific clinical examination and received diagnostic intraarticular sacroiliac joint injections. The centralisation and peripheralisation phenomena were used to identify possible discogenic pain and the results from provocation sacroiliac joint tests were used as part of the clinical reasoning process. Eleven patients had sacroiliac joint pain confirmed by double diagnostic injection. Ten of the 11 sacroiliac joint patients met clinical examination criteria for having sacroiliac joint pain. In the primary subset analysis of 34 patients, sensitivity, specificity and positive likelihood ratio (95% confidence intervals) of the clinical evaluation were 91% (62 to 98), 83% (68 to 96) and 6.97 (2.70 to 20.27) respectively. The diagnostic accuracy of the clinical examination and clinical reasoning process was superior to the sacroiliac joint pain provocation tests alone. A specific clinical examination and reasoning process can differentiate between symptomatic and asymptomatic sacroiliac joints. [Laslett M, Young SB, Aprill CN and McDonald B (2003): Diagnosing painful sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests. Australian Journal of Physiotherapy 49: 89-97] |
| Databáze: | OpenAIRE |
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