Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players

Cook, Jill, Khan, K. M., Kiss, Z. S., Purdam, C. R. and Griffiths, L. 2001, Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players, British journal of sports medicine, vol. 35, no. 1, pp. 65-69.

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Title Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players
Author(s) Cook, Jill
Khan, K. M.
Kiss, Z. S.
Purdam, C. R.
Griffiths, L.
Journal name British journal of sports medicine
Volume number 35
Issue number 1
Start page 65
End page 69
Publisher B M J Publishing Group
Place of publication Loughborough, England
Publication date 2001
ISSN 0306-3674
1473-0480
Keyword(s) patellar tendon
ultrasound
palpation
reliability
athletes
Summary Background—Palpation is an important clinical test for jumper's knee.

Objectives—To (a) test the reproducibility of palpation tenderness, (b) evaluate the sensitivity and specificity of palpation in subjects with clinical symptoms of jumper's knee, and (c) determine whether tenderness to palpation may serve as a useful screening test for patellar tendinopathy. The yardstick for diagnosis of patellar tendinopathy was ultrasonographic abnormality.

Methods—In 326 junior symptomatic and asymptomatic athletes' tendons, palpation was performed by a single examiner before ultrasonographic examination by a certified ultrasound radiologist. In 58 tendons, palpation was performed twice to test reliability. Tenderness to palpation was scored on a scale from 0 to 3 where 0 represented no pain, and 1, 2, and 3 represented mild, moderate, and severe tenderness respectively.

Results—Patellar tendon palpation was a reliable examination for a single examiner (Pearson r = 0.82). In symptomatic tendons, the positive predictive value of palpation was 68%. As a screening examination in asymptomatic subjects, the positive predictive value of tendon palpation was 36–38%. Moderate and severe palpation tenderness were better predictors of ultrasonographic tendon pathology than absent or mild tenderness (p<0.001). Tender and symptomatic tendons were more likely to have ultrasound abnormality than tenderness alone (p<0.01).

Conclusions—In this age group, palpation is a reliable test but it is not cost effective in detecting patellar tendinopathy in a preparticipation examination. In symptomatic tendons, palpation is a moderately sensitive but not specific test. Mild tenderness in the patellar tendons in asymptomatic jumping athletes should be considered normal.
Language eng
Field of Research 110314 Orthopaedics
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2001, British Journal of Sports Medicine
Persistent URL http://hdl.handle.net/10536/DRO/DU:30004249

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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