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Evid Based Med 10:123 doi:10.1136/ebm.10.4.123
  • Diagnosis

Review: no single physical examination sign rules in or out osteoporosis or spinal fracture

Physical examination signs for detecting osteoporosis or spinal fracture in postmenopausal women*

Signs for osteoporosis Number of studies (n) Sensitivity Specificity +LR (95% CI) −LR (CI)
*Diagnostic terms defined in glossary.
Weight <51 kg 1 (1873) 22% 97% 7.3 (5.0 to 10.8) 0.8 ((0.7 to 0.9)
Self reported humped back 1 (2577) 20.6% 97% 3.0 (2.2 to 4.1) 0.85 (0.8 to 0.9)
Kyphosis 1 (610) 25% 92% 3.1 (1.8 to 5.3) 0.8 (0.7 to 1.0)
<20 teeth 1 (190) 27% 92% 3.4 (1.4 to 8.0) 0.8 (0.6 to 1.0)
Signs for spinal fracture
Wall-occiput distance >0 cm 1 (216) 60% 87% 4.6 (2.9 to 7.3) 0.5 (0.3 to 0.6)
Rib-pelvis distance ⩽2 finger breadths 1 (781) 88% 46% 3.8 (2.9 to 5.1) 0.6 (0.5 to 0.7)

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