Cargando…

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

BACKGROUND: 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 manu...

Descripción completa

Detalles Bibliográficos
Autores principales: Sansone, Valerio, Galluzzo, Alessandro, Maiorano, Emanuele, Polatti, Marina Benedetta, Pascale, Valerio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767745/
https://www.ncbi.nlm.nih.gov/pubmed/35042479
http://dx.doi.org/10.1186/s12891-022-05028-y
_version_ 1784634797464748032
author Sansone, Valerio
Galluzzo, Alessandro
Maiorano, Emanuele
Polatti, Marina Benedetta
Pascale, Valerio
author_facet Sansone, Valerio
Galluzzo, Alessandro
Maiorano, Emanuele
Polatti, Marina Benedetta
Pascale, Valerio
author_sort Sansone, Valerio
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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 < 0.00001 in a chi-squared analysis for all quadrants. CONCLUSIONS: PT showed sensitivity and specificity values that are comparable with other clinical tests routinely adopted in clinical practice. In the absence of other reliable clinical test, PT has the potential to become a useful bedside tool in the diagnosis and management of BMLs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-022-05028-y.
format Online
Article
Text
id pubmed-8767745
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-87677452022-01-19 Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee Sansone, Valerio Galluzzo, Alessandro Maiorano, Emanuele Polatti, Marina Benedetta Pascale, Valerio BMC Musculoskelet Disord Research BACKGROUND: 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. METHODS: 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. RESULTS: 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 < 0.00001 in a chi-squared analysis for all quadrants. CONCLUSIONS: PT showed sensitivity and specificity values that are comparable with other clinical tests routinely adopted in clinical practice. In the absence of other reliable clinical test, PT has the potential to become a useful bedside tool in the diagnosis and management of BMLs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-022-05028-y. BioMed Central 2022-01-18 /pmc/articles/PMC8767745/ /pubmed/35042479 http://dx.doi.org/10.1186/s12891-022-05028-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Sansone, Valerio
Galluzzo, Alessandro
Maiorano, Emanuele
Polatti, Marina Benedetta
Pascale, Valerio
Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title_full Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title_fullStr Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title_full_unstemmed Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title_short Percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
title_sort percussion test: description and diagnostic accuracy of a new manual test for bone marrow edema of the knee
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767745/
https://www.ncbi.nlm.nih.gov/pubmed/35042479
http://dx.doi.org/10.1186/s12891-022-05028-y
work_keys_str_mv AT sansonevalerio percussiontestdescriptionanddiagnosticaccuracyofanewmanualtestforbonemarrowedemaoftheknee
AT galluzzoalessandro percussiontestdescriptionanddiagnosticaccuracyofanewmanualtestforbonemarrowedemaoftheknee
AT maioranoemanuele percussiontestdescriptionanddiagnosticaccuracyofanewmanualtestforbonemarrowedemaoftheknee
AT polattimarinabenedetta percussiontestdescriptionanddiagnosticaccuracyofanewmanualtestforbonemarrowedemaoftheknee
AT pascalevalerio percussiontestdescriptionanddiagnosticaccuracyofanewmanualtestforbonemarrowedemaoftheknee