Table 6

Rectus femoris/quadriceps injury diagnosis: effectiveness of clinical tests and grading the quality of evidence

Clinical testsLikelihood ratio
(95% CI)
Diagnostic effectiveness
HighModerateLow/very low
MRI used as reference standard
 Rectus femoris palpation71LR+=11.20 (4.85 to 25.86)Low quality of evidence
LR−=0Moderate quality of evidence
 Resisted hip flexion at 0°71LR+=1.45 (0.90 to 2.32)Moderate quality of evidence
LR−=0.55 (0.15 to 1.79)Low quality of evidence
 Resisted hip flexion at 90°71LR+=2.47 (1.41 to 4.34)Moderate quality of evidence
LR−=0.36 (0.11 to 1.21)Low quality of evidence
 Resisted hip flexion (modified Thomas test position)71LR+=2.36 (1.53 to 3.66)Moderate quality of evidence
LR−=0.20 (0.03 to 1.27)Low quality of evidence
 Resisted knee extension (modified Thomas test position)71LR+=4.17 (2.54 to 6.82)Moderate quality of evidence
LR−=0Moderate quality of evidence
 Passive hip extension (modified Thomas test position)71LR+=2.70 (1.50 to 4.86)Moderate quality of evidence
LR−=0.35 (0.10 to 1.17)Low quality of evidence
 Passive knee flexion (modified Thomas test position)71LR+=5.47 (2.75 to 10.87)Low quality of evidence
LR−=0.15 (0.02 to 0.94)Low quality of evidence
  • MRI; the diagnostic effectiveness of the positive (LR+) and negative (LR−) likelihood ratios are classified individually as: very low (LR+: 1 to 2; LR−: 0.5 to 1), low (LR+: >2 to 5; LR−: 0.2 to <0.5), moderate (LR+: >5 to 10; LR−: 0.1 to <0.2); high (LR+: >10; LR−: <0.1).37