Closed Fist Percussion Sign
Original Editor - Matt Huey
Top Contributors - Matt Huey, Vidya Acharya and Alexandra Stead
Introduction
The closed fist percussion sign is a diagnostic screening tool for determining the need for imaging in individuals with suspected vertebral compression fractures. Vertebral compression fractures can go undiagnosed for prolonged periods of time leading to decreased function and quality of life. Imaging is considered the gold standard however, it can be costly to performing unnecessary imaging. This sign can be a useful assessment tool to determine individuals who would need that imaging.
Technique
How to perform it
- The person is sitting or standing and can have their spine exposed
- The examiner places places one palm over the patient's spine starting in the thoracic spine
- Gently tap the hand over the spinous process with the opposite hand
A positive is a sharp, localised pain at the specific level
Research
In a paper by Langdon et al.[1] 78 people with suspected compression fracture were tested. Imaging was performed to confirm if a fracture was present leading to 48 of the 78 individuals to have a confirmed vertebral compression fracture. Of the 48 individuals, this sign was positive in 42 of the 48 leading to sensitivity of 87.5% and specificity of 90%.
References
- ↑ Langdon, J., Way, A., Heaton, S., Bernard, J., & Molloy, S. (2010). Vertebral compression fractures--new clinical signs to aid diagnosis. Annals of the Royal College of Surgeons of England, 92(2), 163–166