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Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture

Despite its high incidence rate, vertebral fragility fracture (VFF) is frequently underdiagnosed due to the absence of marked symptoms. This study evaluated the diagnostic accuracy of our suggested physical examinations and compared them with that of plain radiographs. Patients over 65 years of age...

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Autores principales: Jung, Chan-Woo, Lee, Jeongik, Ham, Dae-Woong, Kang, Hyun, Chang, Dong-Gune, Kim, Youngbae B., Ahn, Young-Joon, Shim, Joo Hyun, Song, Kwang-Sup
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318760/
https://www.ncbi.nlm.nih.gov/pubmed/35885742
http://dx.doi.org/10.3390/healthcare10071215
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author Jung, Chan-Woo
Lee, Jeongik
Ham, Dae-Woong
Kang, Hyun
Chang, Dong-Gune
Kim, Youngbae B.
Ahn, Young-Joon
Shim, Joo Hyun
Song, Kwang-Sup
author_facet Jung, Chan-Woo
Lee, Jeongik
Ham, Dae-Woong
Kang, Hyun
Chang, Dong-Gune
Kim, Youngbae B.
Ahn, Young-Joon
Shim, Joo Hyun
Song, Kwang-Sup
author_sort Jung, Chan-Woo
collection PubMed
description Despite its high incidence rate, vertebral fragility fracture (VFF) is frequently underdiagnosed due to the absence of marked symptoms. This study evaluated the diagnostic accuracy of our suggested physical examinations and compared them with that of plain radiographs. Patients over 65 years of age with sudden back pain within the preceding 3 weeks were enrolled. Physical examinations in three different positions and a closed-fist percussion test were performed, and the presence of VFF was evaluated through confirmatory radiographic tools. We assessed the diagnostic accuracy of each physical examination and compared them with the interpretation of plain radiographs and examined the patient-reported pain locations based on the VFF level. A total of 179 patients were enrolled. The forward bending in supine (FB-SU) test demonstrated superior diagnostic values (sensitivity: 90.6%, specificity: 71.2%), which outperformed those of plain radiographs (sensitivity: 68.9%, specificity: 71.9%). The location of patient-reported pain was generally close to or lower than the index fracture level. FB-SU showed the highest diagnostic accuracy and was more valuable than plain radiographs in diagnosing acute VFF. FB-SU is a simple and affordable screening test. If positive, physicians should highly suspect VFF even when based on vague evidence of acute fracture provided by plain radiographs.
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spelling pubmed-93187602022-07-27 Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture Jung, Chan-Woo Lee, Jeongik Ham, Dae-Woong Kang, Hyun Chang, Dong-Gune Kim, Youngbae B. Ahn, Young-Joon Shim, Joo Hyun Song, Kwang-Sup Healthcare (Basel) Article Despite its high incidence rate, vertebral fragility fracture (VFF) is frequently underdiagnosed due to the absence of marked symptoms. This study evaluated the diagnostic accuracy of our suggested physical examinations and compared them with that of plain radiographs. Patients over 65 years of age with sudden back pain within the preceding 3 weeks were enrolled. Physical examinations in three different positions and a closed-fist percussion test were performed, and the presence of VFF was evaluated through confirmatory radiographic tools. We assessed the diagnostic accuracy of each physical examination and compared them with the interpretation of plain radiographs and examined the patient-reported pain locations based on the VFF level. A total of 179 patients were enrolled. The forward bending in supine (FB-SU) test demonstrated superior diagnostic values (sensitivity: 90.6%, specificity: 71.2%), which outperformed those of plain radiographs (sensitivity: 68.9%, specificity: 71.9%). The location of patient-reported pain was generally close to or lower than the index fracture level. FB-SU showed the highest diagnostic accuracy and was more valuable than plain radiographs in diagnosing acute VFF. FB-SU is a simple and affordable screening test. If positive, physicians should highly suspect VFF even when based on vague evidence of acute fracture provided by plain radiographs. MDPI 2022-06-29 /pmc/articles/PMC9318760/ /pubmed/35885742 http://dx.doi.org/10.3390/healthcare10071215 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jung, Chan-Woo
Lee, Jeongik
Ham, Dae-Woong
Kang, Hyun
Chang, Dong-Gune
Kim, Youngbae B.
Ahn, Young-Joon
Shim, Joo Hyun
Song, Kwang-Sup
Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title_full Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title_fullStr Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title_full_unstemmed Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title_short Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
title_sort forward bending in supine test: diagnostic accuracy for acute vertebral fragility fracture
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318760/
https://www.ncbi.nlm.nih.gov/pubmed/35885742
http://dx.doi.org/10.3390/healthcare10071215
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