Titre du document / Document title

Pressure-Pain Threshold Algometric Measurement in Patients With Greater Trochanteric Pain After Total Hip Arthroplasty

Auteur(s) / Author(s)

SAYED-NOOR Arkan S. ⁽¹⁾ ; ENGLUND Erling ⁽²⁾ ; WRETENBERG Per ^{(3 4)} ; SJÖDEN Goran O. ^{(1 5)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Orthopaedic Surgery, Sundsvall Hospital, Sundsvall, SUEDE
⁽²⁾ Department of Research and Development, Sundsvall Hospital, Sundsvall, SUEDE
⁽³⁾ Department of Orthopaedic Surgery, Karolinska University Hospital, SUEDE
⁽⁴⁾ Departments of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, SUEDE
⁽⁵⁾ Department of Surgical and Perioperative Sciences, Norrland University Hospital, UmeÅ, SUEDE

Résumé / Abstract

Background: The evaluation of tenderness associated with greater trochanteric pain (GTP) syndrome is amenable to bias and depends on the examiner's experience. In this study, we tested whether the use of an electronic pressure algometer enhanced the reliability of this evaluation. Patients and Methods: Pressure-pain threshold (PPT) was measured with an electronic algometer in 18 patients who developed GTP after total hip arthroplasty and in matched controls. Both groups were evaluated with visual analog scale. Results: The PPT measurements showed large interindividual variability across patients. The correspondence of the PPT measurements in asymptomatic patients was good. We found good validity for the algometer used. The PPT ratio of 0.8 (affected vs. unaffected side) can be used as a cut-off ratio. The PPT measurements at the greater trochanter (local pain) were significantly lower than at the ilio-tibial band (radiated pain). There was no correlation between PPT measurements and visual analog scales. Despite the acceptable sensitivity and specificity of pressure algometer, because of low positive predictive value and large interindividual variability, pressure algometer has a limited value as a screening test. Conclusions: The examination of tenderness associated with GTP is facilitated by the used algometer. It is the intraindividual body-side PPT differences that yield the most sensitive measurement for the assessment of deep pain. A cut-off value of 0.8 can be used for diagnostic purposes. Interindividual differences might be considerable and could mask pathologic diagnostic findings.

Revue / Journal Title

The Clinical journal of pain   ISSN 0749-8047   CODEN CJPAEU 

Source / Source

2008, vol. 24, n^o3, pp. 232-236 [5 page(s) (article)] (29 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams and Wilkins, Hagerstown, MD, ETATS-UNIS  (1985) (Revue)

Mots-clés anglais / English Keywords

Nociception ; Pain sensitivity ; Deep sensitivity ; Hip ; Human ; Pain ; Pressure measurement ; Nervous system diseases ;

Mots-clés français / French Keywords

Nociception ; Sensibilité douleur ; Sensibilité profonde ; Hanche ; Homme ; Douleur ; Mesure pression ; Pathologie du système nerveux ;

Mots-clés espagnols / Spanish Keywords

Nocicepción ; Sensibilidad dolor ; Sensibilidad profunda ; Cadera ; Hombre ; Dolor ; Medida presión ; Sistema nervioso patología ;

Mots-clés d'auteur / Author Keywords

pressure algometer ; pressure-pain threshold ; deep pain sensitivity ; VAS ;

Localisation / Location

INIST-CNRS, Cote INIST : 20743, 35400018358383.0080