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Review: no single physical examination sign rules in or out osteoporosis or spinal fracture
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 Q In patients with osteoporosis, what is the accuracy of physical examination signs for diagnosing osteoporosis or spinal fracture?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Gynaecology ★★★★☆☆☆ Rheumatology ★★★★★★☆ Endocrine ★★★★★★☆

METHODS

Embedded ImageData sources:

Medline (1966 to August 2004), hand searches of bibliographies of relevant articles including recent osteoporosis guidelines and 4 clinical skills textbooks, and contact with experts in the field.

Embedded ImageStudy selection and assessment:

studies that included data on the accuracy or precision of the history or physical examination signs for diagnosing osteoporosis, osteopenia, or spinal fracture and that used bone densitometry at any site or documented vertebral fracture as the gold standard. Studies with insufficient data to calculate likelihood ratios were excluded. Study quality was assessed (level 1 [highest] to level 3).

Embedded ImageOutcomes:

sensitivity, specificity, and …

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