TY - JOUR
T1 - Can elbow-extension test be used as an alternative to radiographs in primary care?
AU - Lamprakis, Andreas
AU - Vlasis, Kostas
AU - Siampou, Ekaterini
AU - Grammatikopoulos, Ilias
AU - Lionis, Christos
PY - 2007/12
Y1 - 2007/12
N2 - Objective: To evaluate the ability of elbow extension, with the patient in a supine position, as a diagnostic test of an insignificant injury, with the purpose of avoiding unnecessary radiographs. Methods: Seventy patients suffering from an acute elbow injury were examined at the accident and emergency department. Inability to fully actively extend the elbow in a supine position was defined as a positive diagnostic test. Radiographs were interpreted by a consultant radiologist, blinded to all clinical examination results. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios along with their 95% confidence intervals were calculated for the elbow-extension test. Results: Forty out of 70 patients had a positive test. Elbow fracture or dislocation was identified radiographically in 22 patients with positive test (sensitivity 92%). Two out of 30 (with negative test) had a hairline radial head fracture, which was found on radiographs (specificity 61%). Conclusion: Elbow extension as a diagnostic test in a primary care setting can predict severe elbow injuries and can be safely used in practices with no radiology facilities.
AB - Objective: To evaluate the ability of elbow extension, with the patient in a supine position, as a diagnostic test of an insignificant injury, with the purpose of avoiding unnecessary radiographs. Methods: Seventy patients suffering from an acute elbow injury were examined at the accident and emergency department. Inability to fully actively extend the elbow in a supine position was defined as a positive diagnostic test. Radiographs were interpreted by a consultant radiologist, blinded to all clinical examination results. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios along with their 95% confidence intervals were calculated for the elbow-extension test. Results: Forty out of 70 patients had a positive test. Elbow fracture or dislocation was identified radiographically in 22 patients with positive test (sensitivity 92%). Two out of 30 (with negative test) had a hairline radial head fracture, which was found on radiographs (specificity 61%). Conclusion: Elbow extension as a diagnostic test in a primary care setting can predict severe elbow injuries and can be safely used in practices with no radiology facilities.
KW - Elbow extension
KW - Elbow injury
KW - Elbow-extension test
KW - General practice
KW - Radiographs
UR - http://www.scopus.com/inward/record.url?scp=40649087452&partnerID=8YFLogxK
U2 - 10.1080/13814780701814820
DO - 10.1080/13814780701814820
M3 - Article
C2 - 18324503
AN - SCOPUS:40649087452
SN - 1381-4788
VL - 13
SP - 221
EP - 224
JO - European Journal of General Practice
JF - European Journal of General Practice
IS - 4
ER -