VALIDITY OF COMBINING HISTORY ELEMENTS AND PHYSICAL EXAMINATION TESTS TO DIAGNOSE PATELLOFEMORAL PAIN

Review written by Dr JF Escullier info

BACKGROUND & OBJECTIVE

Patellofemoral pain (PFP) is a frequent reason for consulting a physiotherapist, and appropriate diagnosis is key to orientate treatment. However, previous studies have only suggested objective examination to diagnose PFP, and have yet to come up with strong diagnostic validity and guidance on which tests should be used. Therefore, the objective of this study was to assess the validity of different combinations of history elements and physical examination tests to diagnose or to exclude PFP in a cohort of participants presenting with various knee disorders.

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METHODS

A total of 279 individuals consulting either a sports physician or orthopaedic surgeon were included. They were also independently evaluated by a physiotherapist on the same day. First, patients’ characteristics and history elements were collected. Then, a combination of physical tests was performed by both the physiotherapist and the physician before they each established a diagnosis of PFP or other knee conditions. The reference standard for diagnosis was made by the physician, who also had access to imaging to exclude other knee conditions. Diagnostic clusters were established using only a combination of history and physical tests, just like a physiotherapist would do in their practice.

RESULTS

Seventy-five (75) individuals were diagnosed with PFP (26.9% of consultations), and 21 variables were associated with the presence or absence of PFP (14 from history, 7 from examination).

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