Diagnostic accuracy of physical examinations to detect acute vertebral fragility fracture
- Conditions
- Diseases of the musculo-skeletal system and connective tissue
- Registration Number
- KCT0002631
- Lead Sponsor
- Chung-Ang Univerisity Hospital
- Brief Summary
1. Demographics A total of 179 patients were enrolled in our study and divided into the fracture group (n = 106) and the non-fracture group (n = 73). The mean age of the patients was 73.96 years (95% CI: 72.84-75.08), of which 35 were men and 144 were women. Demographic data including age, height, weight, BMI, and BMD (lumbar, femur neck, and hip total) demonstrated no significant differences between fracture and non-fracture groups. Seventy-four patients were evaluated for the presence of acute VFF with serial radiograph, 23 patients with CT, and 82 patients with MRI. 2. Diagnostic values of physical examinations FB-SU test demonstrated the most superior diagnostic value compared to other physical examinations with a sensitivity of 90.6%, specificity of 71.2%, and accuracy of 82.7%. Plain radiographic interpretation of acute VFF with clinical symptoms by two raters also had diagnostic value with sensitivity of 68.9%, specificity of 71.9%, and accuracy of 70.12%, thereby underperforming against the accuracy of FB-SU by more than 10%. Other physical examinations including BB-SU, SIT, FB-SI, BB-SI, STAND, SIT-STRAND, and WALK demonstrated extremely low sensitivity values ranging from 14.2% to 37.7% and in contrast, showed higher specificity values ranging from 87.7% to 100%. In case of tenderness, which is the physical examination most frequently performed in clinics, values of sensitivity, specificity, and accuracy were 45.3%, 75.3%, and 57.5% respectively. The McNemar test revealed that only FB-SU and plain radiographic interpretations by the rater 2 demonstrated significant diagnostic values (p > 0.025) compared to confirmatory results. Additional the McNemar test between physical examinations and plain radiographic interpretations by the rater 2 showed that FB-SU was a more valuable diagnostic tool with a higher sensitivity value of 90.6% than the latter’s 69.3%. No significant or minor adverse events occurred as a result of the suggested physical examinations.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 179
Patients with acute back pain more than 60 years olds within 2 weeks
-Patients with low-energy injury compatible with criteria of fragility fracture, injury within own hieght
-Patients with high-energy injury
-Patients without clinical and radiographic evaluation
-Patients having other medical diseases showing back pain
-Patients that disagreed with study and who are not fit for this study in judgment of the researchers
Study & Design
- Study Type
- Observational Study
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The diagnostic accuracy of Forward Trunk-bendingin supine and sitting position
- Secondary Outcome Measures
Name Time Method Midline tenderness, Backward Trunk-bending in supine and sitting position, Sitting for 5 secconds, Standing for 5 seconds, Sitting to Standing and Standing to Sitting, and Walking(10 steps);The diagnostic accuracy of Backward Trunk-extesion in supine and sitting position ;The diagnostic accuracy of Sitting for 5 seconds ;The diagnostic accuracy of Standing for 5 seconds ;The diagnostic accuracy of Standing to sitting, sitting to standing ;The diagnostic accuracy of Waling for 10 steops ;The diagnostic accuracy of radiograph