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Titre du document / Document title

Can tuning forks replace bone scans for identification of tibial stress fractures ?

Auteur(s) / Author(s)

LESHO E. P. (1 2) ;

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

(1) Medical Activity, Fort Richardson, AK, ETATS-UNIS
(2) Department of Medicine, Madigan Army Medical Center, Tacoma, WA, ETATS-UNIS

Résumé / Abstract

Purpose: To compare the performance of the tuning fork test (TFT) with nuclear scintigraphy for the identification of tibial stress fractures. Methods: Fifty-two patients with a history and physical examination suggestive of tibial stress fracture underwent a TFT followed by a bone scan. The TFT was performed by applying a 128-Hz tuning fork to the anterior surface of the bared tibia. If the patient reported a marked exacerbation or reproduction of shin pain in a localized area of the tibia, the TFT was considered positive. All patients also underwent a bilateral lower-extremity bone scan. Results: The sensitivity and specificity of the tuning fork test were 75 and 67%, respectively. The positive and negative predictive values were 77 and 63%, respectively. The positive and negative likelihood ratios with 95% confidence intervals were 2.33 (1.17-4.60) and 0.34 (0.16-0.71), respectively. Conclusion: The tuning fork test is not sensitive enough to rule out a stress fracture on the basis of a negative test. However, in a setting in which there is a moderate to high pretest likelihood of stress fractures, such as military installations with new basic training recruits, it may be reasonable to avoid the cost and delays associated with nuclear imaging by instituting treatment for tibial stress fractures without obtaining a bone scan when the TFT is positive.

Revue / Journal Title

Military medicine    ISSN  0026-4075   CODEN MMEDA9 

Source / Source

1997, vol. 162, no12, pp. 802-803 (10 ref.)

Langue / Language

Anglais

Editeur / Publisher

Association of Military Surgeons, Bethesda, MD, ETATS-UNIS  (1955) (Revue)

Mots-clés anglais / English Keywords

Stress fracture

;

Tibia

;

Scintigraphy

;

Tuning fork

;

Comparative study

;

Clinical test

;

Diagnosis

;

Human

;

Bone

;

Diseases of the osteoarticular system

;

Trauma

;

Radionuclide study

;

Medical imagery

;

Mots-clés français / French Keywords

Fracture fatigue

;

Tibia

;

Scintigraphie

;

Diapason

;

Etude comparative

;

Test clinique

;

Diagnostic

;

Homme

;

Os

;

Système ostéoarticulaire pathologie

;

Traumatisme

;

Exploration radioisotopique

;

Imagerie médicale

;

Mots-clés espagnols / Spanish Keywords

Fractura por tensión

;

Tibia

;

Centelleografía

;

Diapasón

;

Estudio comparativo

;

Prueba clínica

;

Diagnóstico

;

Hombre

;

Hueso

;

Sistema osteoarticular patología

;

Traumatismo

;

Exploración radioisotópica

;

Imageneria medical

;

Localisation / Location

INIST-CNRS, Cote INIST : 2017, 35400007721740.0060

Nº notice refdoc (ud4) : 2096742



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