Table 3

Summary of articles reporting on the diagnostic accuracy of OSTs for pathologies of the hip: fracture of hip or femur

Test, authorsSubjectsAge (mean, SD)GenderPathologySymptom DurationSN/SP (95% CI)LR+/LR-QCriterion standard SN/SP (95% CI)Reliability
Patellar-Pubic Percussion Test
Adams and Yarnold5041 subjectsNRNRFemoral neck, inter-trochanteric, trochanteric and acetabular fractureNR94 (NR)/95 (NR)20.4/0.068Radiograph 90 to 95 (NR)/68 to 100 (NR)8089% inter-rater agreement
Bache and Cross51100 subjects78.6 years82 FFemoral neck fractureNR91 (NR)/82 (NR)5.1/0.118Radiograph 90 to 95 80 (NR)/68 to 100 (NR)NR
Tiru et al52290 subjects72, 6.8 years236 FFemoral neck fractureNR96 (87 to 99)/86 (49 to 98)6.7/0.7510Radiograph 90 to 95 (NR)/68 to 100 (NR)80; Bone scan 91(NR)/100 (NR) 81; MRI 100 (NR)/100 (NR)81; CT; NRNR
Stress Fracture (Fulcrum) Test
Johnson et al537 subjects19.8 years4 FProximal 1/3 femoral shaft stress fractureNR93 (NR)/75 (NR)3.7/0.095Bone scan 91(NR)/100 (NR) 81; Radiograph 90 to 95 (NR)/68 to 100 (NR)80NR
Kang et al546 subjectsRange 19–23 years6 FFemoral shaft stress fractureNR88 (NR)/13 (NR)1.0/0.927Radiograph 90 to 95 (NR)/68 to 100 (NR) 80; Bone scan 91(NR)/100 (NR) 81; MRI 100 (NR)/100 (NR) 81NR
  • 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 (%).