Shetty test in ankle and foot trauma: An emergency department pilot study assessing specificity and sensitivity

Abstract

ObjectiveTo assess the potential impact of the Shetty test over Ottawa ankle foot rules (OAFR) on plain imaging utilisation in the ED.MethodsNursing and medical staff assessed both Shetty test and OAFR in ED. All patients received ankle and foot radiographs.ResultsFifty‐four participants were assessed. Shetty test specificity at triage was 0.40 (95% CI 0.25–0.57), compared to OAFR 0.10 (95% CI 0.03–0.24), McNemar's P < 0.01. Shetty test and OAFR sensitivity at triage was 0.92 (95% CI 0.64–0.99), McNemar's P = 1.00.ConclusionShetty test may safely reduce unneeded radiographs in ED. Further research is warranted.

The Shetty Test’s Performance in Predicting Fractures in Radiography for Pediatric Patients

“…Furthermore, previous studies related to the ST have primarily focused on the presence of fractures. [1][2][3]7 Therefore, the significant difference in the distribution of radiography findings observed in the current study could encourage the development of new scoring systems that incorporate both physical examination findings and the ST to determine fracture subtypes.…”

“…The most common cause of ankle trauma in our study was determined to be sprain (65%), which is consistent with findings from similar studies that also identified sprains as the leading cause of injury. 2,21 It has been reported that in many healthcare institutions, ankle trauma patients are often sent directly to the radiography unit before undergoing a physical examination. 3,16,21,22 The aim of this study was to evaluate the diagnostic success of the ST in predicting fractures in pediatric cases.…”

“…While the majority of studies have focused on adult patients, there are also studies that have included patients from the lower age limit of the pediatric population. 2,3,21 In a study evaluating 50 patients with isolated ankle trauma, where the ST was introduced for the first time, the reported sensitivity, specificity, PPV, and NPV were 100%, 91%, 43%, and 100%, respectively. 7 Another study reported values of sensitivity 95.5%, specificity 100%, PPV 71.40%, and NPV 100% for the ST, and highlighted that the ST reduced radiography indications at similar rates to the OAR, which were evaluated in the same population.…”

“…Foot and ankle traumas are the most common extremity injuries, representing a significant portion of Emergency Department (ED) presentations. 1,2 In the majority of these cases, the trauma affects the ligaments, ankle joint capsule, or results in soft tissue contusion. 3 Despite this, diagnostic radiographs are often requested for these patients, regardless of clinical indications.…”

Reappraisal of the Use of X-Rays in Acute Ankle and Midfoot Injuries. A Prospective Evaluation of the Ottawa Ankle Rules (OAR) in a Single Tertiary Trauma Centre

“…To reduce the need for radiography in patients with acute ankle and foot trauma, various prediction rules have been developed. 5,6,7,8 The Ottawa Ankle Rules (OAR) is one of the internationally recognized prediction tools developed to evaluate these injuries in deciding on the need for radiographs. It is wellvalidated and has been included in many clinical practice guidelines worldwide.…”