TY - JOUR
T1 - Physical examination of the elbow, what is the evidence? A systematic literature review
AU - Zwerus, Elisa L.
AU - Somford, Matthijs P.
AU - Maissan, François
AU - Heisen, Jelle
AU - Eygendaal, Denise
AU - Van Den Bekerom, Michel Pj
PY - 2018/10
Y1 - 2018/10
N2 - Objective Primary to provide an overview of diagnostic accuracy for clinical tests for common elbow (sport) injuries, secondary accompanied by reproducible instructions to perform these tests. Design A systematic literature review according to the PRISMA statement. Data sources A comprehensive literature search was performed in MEDLINE via PubMed and EMBASE. Eligibility criteria We included studies reporting diagnostic accuracy and a description on the performance for elbow tests, targeting the following conditions: distal biceps rupture, triceps rupture, posteromedial impingement, medial collateral ligament (MCL) insufficiency, posterolateral rotatory instability (PLRI), lateral epicondylitis and medial epicondylitis. After identifying the articles, the methodological quality was assessed using the QUADAS-2 checklist. Results Our primary literature search yielded 1144 hits. After assessment 10 articles were included: six for distal biceps rupture, one for MCL insufficiency, two for PLRI and one for lateral epicondylitis. No articles were selected for triceps rupture, posteromedial impingement and medial epicondylitis. Quality assessment showed high or unclear risk of bias in nine studies. We described 24 test procedures of which 14 tests contained data on diagnostic accuracy. Conclusions Numerous clinical tests for the elbow were described in literature, seldom accompanied with data on diagnostic accuracy. None of the described tests can provide adequate certainty to rule in or rule out a disease based on sufficient diagnostic accuracy.
AB - Objective Primary to provide an overview of diagnostic accuracy for clinical tests for common elbow (sport) injuries, secondary accompanied by reproducible instructions to perform these tests. Design A systematic literature review according to the PRISMA statement. Data sources A comprehensive literature search was performed in MEDLINE via PubMed and EMBASE. Eligibility criteria We included studies reporting diagnostic accuracy and a description on the performance for elbow tests, targeting the following conditions: distal biceps rupture, triceps rupture, posteromedial impingement, medial collateral ligament (MCL) insufficiency, posterolateral rotatory instability (PLRI), lateral epicondylitis and medial epicondylitis. After identifying the articles, the methodological quality was assessed using the QUADAS-2 checklist. Results Our primary literature search yielded 1144 hits. After assessment 10 articles were included: six for distal biceps rupture, one for MCL insufficiency, two for PLRI and one for lateral epicondylitis. No articles were selected for triceps rupture, posteromedial impingement and medial epicondylitis. Quality assessment showed high or unclear risk of bias in nine studies. We described 24 test procedures of which 14 tests contained data on diagnostic accuracy. Conclusions Numerous clinical tests for the elbow were described in literature, seldom accompanied with data on diagnostic accuracy. None of the described tests can provide adequate certainty to rule in or rule out a disease based on sufficient diagnostic accuracy.
KW - diagnosis
KW - elbow
KW - examination
KW - sporting injuries
KW - testing
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U2 - 10.1136/bjsports-2016-096712
DO - 10.1136/bjsports-2016-096712
M3 - Review article
C2 - 28249855
AN - SCOPUS:85054094448
SN - 0306-3674
VL - 52
SP - 1253
EP - 1260
JO - BJSM - British Journal of Sports Medicine
JF - BJSM - British Journal of Sports Medicine
IS - 19
ER -