Diagnostics

Question 1

+LR 1 - Interpretation

Answer 1

No change in the likelihood of the disease

Question 2

+LR 1-2 - Interpretation

Answer 2

Minimal increase in the likelihood of the disease

Question 3

+LR 2-5 - Interpretation

Answer 3

Small increase in the likelihood of the disease

Question 4

+LR 5-10 - Interpretation

Answer 4

Moderate increase in the likelihood of the disease

Question 5

+LR >10 - Interpretation

Answer 5

Large and often conclusive increase in the likelihood of the disease

Question 6

-LR 1 - Interpretation

Answer 6

No change in the likelihood of the disease

Question 7

-LR (0.5 -1) - Interpretation

Answer 7

Minimal decrease in the likelihood of the disease

Question 8

-LR (0.2 -0.5) - Interpretation

Answer 8

Small decreases in the likelihood of the disease

Question 9

-LR (0.1 -0.2) - Interpretation

Answer 9

Moderate decrease in the likelihood of the disease

Question 10

-LR (<0.1) - Interpretation

Answer 10

Large and often conclusive decrease in the likelihood of the disease

Question 11

Lumbar Extension Centralization

Answer 11

Lumbar Radiculopathy
Specificity: 94
+LR: 6.7
-LR: 0.12

Question 12

Ankylosing Spondylitis

Answer 12

• Age of onset <40
• Pain not relieved by supine
• Morning back stiffness
• Pain duration >3 months

4 of 5 questions with: improved with exercise
+LR: 1.27

Question 13

Pelvic Fracture

Answer 13

• No pain during compression
• Positive Pubic Percussion Test (+LR = 9 - 313)
• Hip Flexion Test: active SLR (Sn: 90, Sp: 95)

Question 14

SIJ Pain Provocation Tests

Answer 14

3 of 5 = +LR 4.16 (Sn: 91; Sp: 87)

• SI Compression Test: hold 30 seconds and bounce at end
• SIJ Gapping: hold 30 seconds and bounce at end
• Sacral Thrust: 3 to 5 hard thrusts
• Thigh Thrust: hold 30 seconds and bounce at end
• Gaenslen’s Test: Thomas test with 3 to 5 torsions

Question 15

Canadian C-Spine Rule

Answer 15

• Sn: 1; Sp: .43
• High Risk Factors
  
  • Over 65 y/o
  • Dangerous Mechanism
    
    • Fall over 3 feet or 5 stairs,
    • Axial load to head,
    • Cycle collision,
    • Motorized RV MVC >60 MPH/roll/ejection
  • Extremity paresthesias
• Low risk factors allowing safe assessment of ROM
  
  • Simple rear end
  • Sitting in ER
  • Ambulatory at any time
  • Delayed onset of neck pain
  • Absence of midline tenderness
• Able to rotate head actively 45* both directions

No&raquo_space; Yes&raquo_space; Yes = No x-ray