Diagnostic Accuracy of History Taking and Physical Examination for Assessing Anterior Cruciate Ligament Lesions of the Knee in Primary Care

Abstract

ACL lesions are seen frequently. Based on history taking (effusion, popping sensation, and/or giving way) and physical examination (ADT), GPs can screen for ACL lesions in primary care.

Stress Radiography for the Diagnosis of Knee Ligament Injuries: A Systematic Review

“…Compared with physical examination, stress radiographs provide a quantifiable and retrievable record of instability. Physical examination alone has often been reported to be inaccurate, subjective, and poorly reproducible for assessing anterior knee laxity [3,23,49,53]. Clinician experience, a patient's pain, tolerance of the examination, and concurrent ligamentous injuries may skew physical examination interpretation, detracting in certain situations from its clinical use [22,25,27].…”

Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: a systematic review

“…Uninterpretable index test outcomes, such as an equivocal finding were dealt with as a negative index test finding. The authors of one study [19] were contacted and provided additional information.…”

“…Of the 14 included articles, 10 had a prospective study design [19,23,24,[28][29][30][32][33][34][35], two used a retrospective design [26,27] and for two studies [25,31] the design was unclear (Table 1).…”

“…Forwards and backwards citation tracking identified 12 potentially relevant articles which were also retrieved. Fourteen articles were finally included, of which 11 were published in English [19,[23][24][25][26][27][28][29][30][31][32] and three in German [33][34][35]. Additional file 2: Table S2 lists the reasons for excluding 28 articles that were included in one or more of the previous five systematic reviews.…”

Predictors of persistent complaints after a knee injury in primary care

“…17,18 In primary care, however, the use of MRI in knee injuries is not yet common practice, but is slowly being introduced. It has previously been shown that patient characteristics, history taking, and physical examination have limited value in diagnosing meniscal and ligament damage; [19][20][21] as MRI is an additional tool in diagnosing such damage, 17,18 it is worthwhile to establish whether or not it has additive prognostic value in primary care.…”