Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon

Verfasser / Beitragende:
[Stijn Geraets, Duncan Meuffels, Belle van Meer, Hans Breedveldt Boer, Sita Bierma-Zeinstra, Max Reijman]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/4(2015-04-01), 968-974
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-013-2769-4  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-013-2769-4 
245 0 0 |a Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon  |h [Elektronische Daten]  |c [Stijn Geraets, Duncan Meuffels, Belle van Meer, Hans Breedveldt Boer, Sita Bierma-Zeinstra, Max Reijman] 
520 3 |a Purpose: Well-designed validity studies on the clinical diagnosis of anterior cruciate ligament (ACL) injury are scarce. Our purpose is to assess the diagnostic value of ACL-specific medical history assessment and physical examination between primary and secondary care medical specialists. Methods: Medical history assessment and physical examination were performed by both an orthopaedic surgeon and a primary care physician, both blinded to all clinical information, in a secondary care population. A knee arthroscopy was used as reference standard. A total of 60 participants were divided into an index group with an arthroscopically proven complete ACL rupture and a control group with an arthroscopically proven intact ACL. Results: The orthopaedic surgeon recognized 94% of the participants with an ACL rupture through a positive medical history combined with a positive physical examination; of the participants with an intact ACL, 16% were misclassified by the orthopaedic surgeon. The primary care physician recognized 62% of the participants with an ACL rupture and misclassified 23% of the participants with an intact ACL. Physical examination appeared to have no additional value for the primary care physician. Conclusions: Combined medical history and physical examination have strong diagnostic value in ACL rupture diagnostics performed by an orthopaedic surgeon, whereas for the primary care physician, only medical history appeared to be of value. For current practice, this could mean that only orthopaedic surgeons can perform an ACL physical examination with accuracy. Level of evidence: III. 
540 |a Springer-Verlag Berlin Heidelberg, 2013 
690 7 |a Diagnostic value  |2 nationallicence 
690 7 |a ACL rupture  |2 nationallicence 
690 7 |a Medical history assessment  |2 nationallicence 
690 7 |a Physical examination  |2 nationallicence 
700 1 |a Geraets  |D Stijn  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
700 1 |a Meuffels  |D Duncan  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
700 1 |a van Meer  |D Belle  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
700 1 |a Breedveldt Boer  |D Hans  |u Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
700 1 |a Bierma-Zeinstra  |D Sita  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
700 1 |a Reijman  |D Max  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 968-974  |x 0942-2056  |q 23:4<968  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-013-2769-4  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-013-2769-4  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Geraets  |D Stijn  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Meuffels  |D Duncan  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a van Meer  |D Belle  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Breedveldt Boer  |D Hans  |u Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bierma-Zeinstra  |D Sita  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Reijman  |D Max  |u Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 968-974  |x 0942-2056  |q 23:4<968  |1 2015  |2 23  |o 167