caa a22 4500 605458901 CHVBK 20210128100231.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00167-013-2769-4 doi (NATIONALLICENCE)springer-10.1007/s00167-013-2769-4 Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon [Elektronische Daten] [Stijn Geraets, Duncan Meuffels, Belle van Meer, Hans Breedveldt Boer, Sita Bierma-Zeinstra, Max Reijman] 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. Springer-Verlag Berlin Heidelberg, 2013 Diagnostic value nationallicence ACL rupture nationallicence Medical history assessment nationallicence Physical examination nationallicence Geraets Stijn Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut Meuffels Duncan Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut van Meer Belle Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut Breedveldt Boer Hans Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands aut Bierma-Zeinstra Sita Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut Reijman Max Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 968-974 0942-2056 23:4<968 2015 23 167 https://doi.org/10.1007/s00167-013-2769-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2769-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Geraets Stijn Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Meuffels Duncan Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Meer Belle Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Breedveldt Boer Hans Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Bierma-Zeinstra Sita Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Reijman Max Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 968-974 0942-2056 23:4<968 2015 23 167