Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee

Prompt diagnosis of bone marrow lesion (BML) is difficult but critical for correct treatment. Magnetic resonance imaging is the gold standard, although expensive and time consuming. Simple and reliable clinical test for BML detection is lacking. Aim of the study is to describe a new manual clinical...

Full description

Saved in:
Bibliographic Details
Published in:BMC musculoskeletal disorders 2022-01, Vol.23 (1), p.68-68, Article 68
Main Authors: Sansone, Valerio, Galluzzo, Alessandro, Maiorano, Emanuele, Polatti, Marina Benedetta, Pascale, Valerio
Format: Article
Language:English
Subjects:
Accuracy
Adolescent
Adult
Age
Aged
Aged, 80 and over
Biopsy
Bone edema
Bone marrow
Bone Marrow - diagnostic imaging
Bone Marrow Diseases - diagnostic imaging
Bone marrow examination
Bone marrow lesion
Care and treatment
Clinical medicine
Diagnosis
Diagnostic accuracy
Diagnostic imaging
Dropsy
Edema
Humans
Knee
Knee Joint - diagnostic imaging
Knee pain
Magnetic Resonance Imaging
Medical diagnosis
Methods
Middle Aged
Musculoskeletal diseases
Observational studies
Osteoarthritis, Knee
Pain
Patients
Percussion
Physical examination
Prospective Studies
Risk factors
Values
Young Adult
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Prompt diagnosis of bone marrow lesion (BML) is difficult but critical for correct treatment. Magnetic resonance imaging is the gold standard, although expensive and time consuming. Simple and reliable clinical test for BML detection is lacking. Aim of the study is to describe a new manual clinical test called Percussion Test (PT) and to statistically determine its diagnostic accuracy in BML, compared to MRI imaging. After evaluation of the inclusion and exclusion criteria, 218 consecutive patients with unilateral knee pain and age comprised between 18 and 80 years old were enrolled in our observational prospective study. Informed consent was obtained for each patient. After medical history collection, PT was performed by a single operator as described. MRI was performed in the affected knee to detect the presence of BML. Coherence in PT and MRI assessment was evaluated in each quadrant of the knee via contingency tables, as sensitivity, specificity, NPV, PPV and diagnostic accuracy were calculated. No correlation with a positive PT was demonstrated for the covariables gender (p = 0.156), age (p = 0.272) and BMI (p = 0.639). PT showed a sensitivity ranging from 60.6 (40.6-80.6) to 79.5 (63.0-96.0) and a specificity ranging from 85.7 (80.0-91.5) to 96.0 (93.1-98.9) depending on knee quadrant. Diagnostic accuracy ranged from 81.6 (75.9-86.6) to 89.4 (84.6-93.2), and p-value was
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-022-05028-y