Summary of articles reporting on the diagnostic accuracy of OSTs for pathologies of the hip: fracture of hip or femur
| Test, authors | Subjects | Age (mean, SD) | Gender | Pathology | Symptom Duration | SN/SP (95% CI) | LR+/LR- | Q | Criterion standard SN/SP (95% CI) | Reliability |
|---|---|---|---|---|---|---|---|---|---|---|
| Patellar-Pubic Percussion Test | ||||||||||
| Adams and Yarnold50 | 41 subjects | NR | NR | Femoral neck, inter-trochanteric, trochanteric and acetabular fracture | NR | 94 (NR)/95 (NR) | 20.4/0.06 | 8 | Radiograph 90 to 95 (NR)/68 to 100 (NR)80 | 89% inter-rater agreement |
| Bache and Cross51 | 100 subjects | 78.6 years | 82 F | Femoral neck fracture | NR | 91 (NR)/82 (NR) | 5.1/0.11 | 8 | Radiograph 90 to 95 80 (NR)/68 to 100 (NR) | NR |
| Tiru et al52 | 290 subjects | 72, 6.8 years | 236 F | Femoral neck fracture | NR | 96 (87 to 99)/86 (49 to 98) | 6.7/0.75 | 10 | Radiograph 90 to 95 (NR)/68 to 100 (NR)80; Bone scan 91(NR)/100 (NR) 81; MRI 100 (NR)/100 (NR)81; CT; NR | NR |
| Stress Fracture (Fulcrum) Test | ||||||||||
| Johnson et al53 | 7 subjects | 19.8 years | 4 F | Proximal 1/3 femoral shaft stress fracture | NR | 93 (NR)/75 (NR) | 3.7/0.09 | 5 | Bone scan 91(NR)/100 (NR) 81; Radiograph 90 to 95 (NR)/68 to 100 (NR)80 | NR |
| Kang et al54 | 6 subjects | Range 19–23 years | 6 F | Femoral shaft stress fracture | NR | 88 (NR)/13 (NR) | 1.0/0.92 | 7 | Radiograph 90 to 95 (NR)/68 to 100 (NR) 80; Bone scan 91(NR)/100 (NR) 81; MRI 100 (NR)/100 (NR) 81 | NR |
F, female; LR+, positive likelihood ratio; LR-, negative likelihood ratio; NR, not reported; OST, orthopaedic special tests; Q, Quality Assessment of Diagnostic Accuracy Studies scores; SN, sensitivity (%); SP, specificity (%).