Patellar-Pubic Percussion Test: Difference between revisions

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{{#ev:youtube|bZccYojlDvQ|250}} <ref>BJSM Videos. Patellar pubic percussion test, with Mike Reiman. Available from: http://www.youtube.com/watch?v=bZccYojlDvQ [last accessed 25/01/14]</ref>
{{#ev:youtube|bZccYojlDvQ|250}} <ref>BJSM Videos. Patellar pubic percussion test, with Mike Reiman. Available from: http://www.youtube.com/watch?v=bZccYojlDvQ [last accessed 25/01/14]</ref>


== Sensitivity/Specificity ==
Tiru et al<ref name="Tiru et al">Tiru M, Goh SH, Low BY. Use of percussion as a screening tool in the diagnosis of occult hip fractures. Singapore Med J 2002;43:467-469.</ref> found a sensitivity of .96 and a specificity of .86 for the PPPT in the diagnosis of femoral neck fractures.


== Evidence  ==
== Evidence  ==


In the United States hip fractures have a yearly incidence of about 300,000.&nbsp; This number is expected to double or possibly triple by the year 2040.&nbsp; Morbidity and mortality are reported to be as high as 14-36% in the first year after injury.<ref name="Perron et al">Perron AD, Miller MD, Brady WJ. Orthopedic Pitfalls in the ED: Radiographically occult hip fracture. Am J Emerg Med 2002;20:234-237.</ref><ref name="Brunner et al">Brunner LC, Eshilian-Oates L, Duo TY. Hip Fractures in adults.Am Fam Phys 2003;68:537-542.</ref> In 2-10% of those patients that present to the ER with a painful hip after trauma, initial radiographs will not show the occult fracture.<ref name="Lubovsky et al">Lubovsky O, Liebergall M, Mattan Y, Weil Y, Moshieff R. Early diagnosis of occult hip fractures: MRI versus CT scan. Injury Int J Care Injured 2005;36:788-792.</ref> Adams and Yarnold<ref name="Adams et al">Adams SL, Yarnold PR. Clinical use of the patellar pubic percussion sign in hip trauma. Am J Emerg Med 1997;15:173-175.</ref> reported an interrater agreement of 90.2% for the PPPT. In a study of 290 patients with post-traumatic hip pain, inability to ambulate due to pain and negative radiographs, Tiru et al<ref name="Tiru et al">Tiru M, Goh SH, Low BY. Use of percussion as a screening tool in the diagnosis of occult hip fractures. Singapore Med J 2002;43:467-469.</ref> found a sensitivity of .96 and a specificity of .86 for the PPPT in the diagnosis of femoral neck fractures.
In the United States hip fractures have a yearly incidence of about 300,000.&nbsp; This number is expected to double or possibly triple by the year 2040.&nbsp; Morbidity and mortality are reported to be as high as 14-36% in the first year after injury.<ref name="Perron et al">Perron AD, Miller MD, Brady WJ. Orthopedic Pitfalls in the ED: Radiographically occult hip fracture. Am J Emerg Med 2002;20:234-237.</ref><ref name="Brunner et al">Brunner LC, Eshilian-Oates L, Duo TY. Hip Fractures in adults.Am Fam Phys 2003;68:537-542.</ref> In 2-10% of those patients that present to the ER with a painful hip after trauma, initial radiographs will not show the occult fracture.<ref name="Lubovsky et al">Lubovsky O, Liebergall M, Mattan Y, Weil Y, Moshieff R. Early diagnosis of occult hip fractures: MRI versus CT scan. Injury Int J Care Injured 2005;36:788-792.</ref> Adams et al<ref name="Adams et al">Adams SL, Yarnold PR. Clinical use of the patellar pubic percussion sign in hip trauma. Am J Emerg Med 1997;15:173-175.</ref> reported an interrater agreement of 90.2% for the PPPT.  


== References  ==
== References  ==

Revision as of 16:14, 28 February 2021

Original Editor - Michael Conaway

Top Contributors - Admin, Michael Conaway, Kim Jackson, Laura Ritchie, Fasuba Ayobami, WikiSysop, 127.0.0.1, Tony Lowe, Evan Thomas, Kai A. Sigel and Claire Knott

Purpose[edit | edit source]

To identify occult hip fractures.

Photo: Mike Conaway


Technique[edit | edit source]

The Patellar-Pubic Percussion Test is a form of Osteophony or auscultatory percussion which is used in the assessment of bone integrity by analyzing its vibrations through the use of a stethoscope and bony prominence percussion.Cite error: Invalid <ref> tag; invalid names, e.g. too many

[1]

Sensitivity/Specificity[edit | edit source]

Tiru et al[2] found a sensitivity of .96 and a specificity of .86 for the PPPT in the diagnosis of femoral neck fractures.

Evidence[edit | edit source]

In the United States hip fractures have a yearly incidence of about 300,000.  This number is expected to double or possibly triple by the year 2040.  Morbidity and mortality are reported to be as high as 14-36% in the first year after injury.[3][4] In 2-10% of those patients that present to the ER with a painful hip after trauma, initial radiographs will not show the occult fracture.[5] Adams et al[6] reported an interrater agreement of 90.2% for the PPPT.

References[edit | edit source]

  1. ↑ BJSM Videos. Patellar pubic percussion test, with Mike Reiman. Available from: http://www.youtube.com/watch?v=bZccYojlDvQ [last accessed 25/01/14]
  2. ↑ Tiru M, Goh SH, Low BY. Use of percussion as a screening tool in the diagnosis of occult hip fractures. Singapore Med J 2002;43:467-469.
  3. ↑ Perron AD, Miller MD, Brady WJ. Orthopedic Pitfalls in the ED: Radiographically occult hip fracture. Am J Emerg Med 2002;20:234-237.
  4. ↑ Brunner LC, Eshilian-Oates L, Duo TY. Hip Fractures in adults.Am Fam Phys 2003;68:537-542.
  5. ↑ Lubovsky O, Liebergall M, Mattan Y, Weil Y, Moshieff R. Early diagnosis of occult hip fractures: MRI versus CT scan. Injury Int J Care Injured 2005;36:788-792.
  6. ↑ Adams SL, Yarnold PR. Clinical use of the patellar pubic percussion sign in hip trauma. Am J Emerg Med 1997;15:173-175.
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