Poor sensitivity of musculoskeletal history in children
- 1Department of Rheumatology, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
- 2Department of Medicine, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
- 3Department of Paediatrics, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
- Correspondence to Iain Goff, Newcastle upon Tyne NHS Foundation Trust, Rheumatology, Newcastle upon Tyne NE7 7DN, UK;
Contributors All authors have contributed to the design, conduct and analysis of this study. All authors have contributed to the writing of this paper and have approved the final version.
- Received 19 August 2011
- Accepted 29 January 2012
- Published Online First 13 April 2012
Objectives To demonstrate the sensitivity of musculoskeletal (MSK) history taking.
Design Prospective study: consecutive children attending outpatient clinics.
Setting and patients Paediatric rheumatology clinic (n=45; girls n=28; median age 12 years, range 3–18), acute general paediatric assessment unit (n=50; girls n=21; median age 8 years, range 3–16).
Intervention Pro forma recording abnormal joint involvement from history taking and then following MSK examination completed by clinicians.
Main outcome measures Sensitivity of MSK history taking compared with clinical examination.
Results Paediatric rheumatology clinic: 135 abnormal joints identified in 34 children; 53/135 (39%) by history alone, 82/135 (61%) detected on examination resulting in MSK history sensitivity 53%, specificity 98%. Acute paediatric unit: 29 abnormal joints identified in 17 children; 18/29 identified on history (sensitivity 62%).
Conclusions MSK history taking failed to identify a large number of abnormal joints which were detected on physical examination, emphasising the need for all joints to be examined as part of a screening examination as a minimum.
Competing interests None.
Ethics approval Approval provided by the Northumberland Regional Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed