Poor sensitivity of musculoskeletal history in children

Newcastle upon Tyne NHS Foundation Trust, Rheumatology, Newcastle upon Tyne NE7 7DN, UK.
Archives of Disease in Childhood (Impact Factor: 2.91). 04/2012; 97(7):644-6. DOI: 10.1136/archdischild-2011-300853
Source: PubMed

ABSTRACT To demonstrate the sensitivity of musculoskeletal (MSK) history taking.
Prospective study: consecutive children attending outpatient clinics.
Paediatric rheumatology clinic (n=45; girls n=28; median age 12 years, range 3-18), acute general paediatric assessment unit (n=50; girls n=21; median age 8 years, range 3-16).
Pro forma recording abnormal joint involvement from history taking and then following MSK examination completed by clinicians.
Sensitivity of MSK history taking compared with clinical examination.
Paediatric rheumatology clinic: 135 abnormal joints identified in 34 children; 53/135 (39%) by history alone, 82/135 (61%) detected on examination resulting in MSK history sensitivity 53%, specificity 98%. Acute paediatric unit: 29 abnormal joints identified in 17 children; 18/29 identified on history (sensitivity 62%).
MSK history taking failed to identify a large number of abnormal joints which were detected on physical examination, emphasising the need for all joints to be examined as part of a screening examination as a minimum.

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