TY - JOUR T1 - Review: no single physical examination sign rules in or out osteoporosis or spinal fracture JF - Evidence Based Medicine JO - Evid Based Med SP - 123 LP - 123 DO - 10.1136/ebm.10.4.123 VL - 10 IS - 4 A2 - , Y1 - 2005/08/01 UR - http://ebm.bmj.com/content/10/4/123.abstract N2 - Green AD, Colón-Emeric CS, Bastian L, et al. Does this woman have osteoporosis? JAMA 2004;292:2890–900.OpenUrlCrossRefPubMedWeb of Science 
 
 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 ★★★★★★☆ Data 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. Study 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). Outcomes: sensitivity, specificity, and … ER -