Background
Methods
Study design and settings
Participants
Data collection procedure
Patients’ characteristics and history elements
Physical examination
Diagnosis, reference standard and triage options
Standardisation and evaluators’ experience
Sample size
Statistical analysis
Results
Characteristics | n (%) | mean (SD) |
---|---|---|
Age (years) | 49.9 (16.1) | |
Sex | ||
Female | 114 (64) | |
Male | 65 (36) | |
Body Mass Index (Kg\m2) | 29.1 (6.5) | |
Recruitment site | ||
Orthopaedic clinic | 142 (80) | |
Family medicine unit | 15 (8) | |
University community | 22 (12) | |
History of trauma | 47 (26) | |
Bilateral knee pain | 39 (22) | |
Duration of pain at time of consultation | ||
<3 months | 17 (10) | |
3–12 months | 45 (25) | |
≥ 12 months | 117 (65) | |
KOOS- Knee Injury and Osteoarthritis Outcome Score (%) | ||
Pain | 58.6 (19.7) | |
Symptoms | 71.0 (19.6) | |
Activity of Daily Living | 66.1 (21.8) | |
Sports | 31.4 (24.8) | |
Quality of Life | 40.9 (20.3) | |
K6 psychological distress scale (/30) | 26.0 (4.5) |
n (%) | |
---|---|
Primary clinical composite diagnoses | |
Anterior cruciate ligament injury | 8 (5) |
Meniscal injury | 36 (20) |
Patellofemoral Pain Syndrome | 45 (25) |
Osteoarthritis | 79 (44) |
Other knee diagnoses | 11 (6) |
Imaging findings and diagnoses | |
Osteoarthritis | 96 (56) |
K-L Grade 1 | 14 (15) |
K-L Grade 2 | 36 (38) |
K-L Grade 3 | 19 (20) |
K-L Grade 4 | 13 (14) |
Meniscal tears (n) | 54 (32) |
Medial meniscus | 49 (91) |
Lateral meniscus | 8 (15) |
Anterior cruciate ligament tears | 16 (9) |
Complete | 6 (37) |
Partial | 8 (50) |
Unclear | 2 (13) |
Posterior cruciate ligament tear | 1 (1) |
Soleus tear | 1 (1) |
Hamstring tendinopathy | 2 (1) |
Medial collateral ligament tear | 1 (1) |
Raw agreement | Cohen’s kappa | 95% CI | Bias Index | Prevalence Index | PABAK | |
---|---|---|---|---|---|---|
Overall concordance with the physicians’ composite diagnoses | 92.2% (165/179) | 0.89 | 0.83–0.94 | – | – | – |
ACL injury | 100.0% (8/8) | 0.94 | 0.82–1.00 | 0.01 | 0.91 | 0.99 |
Meniscal injury | 97.2% (35/36) | 0.88 | 0.80–0.93 | 0.03 | 0.57 | 0.92 |
Patellofemoral pain | 91.1% (41/45) | 0.88 | 0.80–0.96 | 0.05 | 0.50 | 0.91 |
Osteoarthritis | 91.1% (72/79) | 0.89 | 0.82–0.95 | 0.02 | 0.14 | 0.89 |
Other knee disorders | 81.8% (9/11) | 0.89 | 0.75–1.00 | 0.01 | 0.89 | 0.98 |
Overall concordance with imaging only diagnoses | 84.4% (151/179) | 0.77 | 0.68–0.85 | – | – | – |
Sensitivity (95% CI) | Specificity (95% CI) | Positive Likelihood Ratio (95% CI) | Negative Likelihood Ratio (95% CI) | |
---|---|---|---|---|
ACL injuries (n = 8) | 100.0% (52.0–100.0) | 99.0% (97.0–100.0) | 171.0 (24.2–1207.0) | 0.00 (0.00–0.00) |
Meniscal injuries (n = 36) | 97.0% (85.0–100.0) | 96.0% (91.0–98.0) | 23.2 (10.6–50.8) | 0.03 (0.00–0.20) |
Patellofemoral pain (n = 45) | 91.0% (79.0–98.0) | 97.0% (93.0–99.0) | 30.5 (11.6–80.5) | 0.09 (0.04–0.23) |
Osteoarthritis (n = 79) | 91.0% (83.0–96.0) | 97.0% (91.0–99.0) | 30.4 (10.0–92.8) | 0.09 (0.04–0.19) |
Others knee disorders (n = 11) | 82.0% (48.0–98.0) | 100.0% (97.0–100.0) | 267.6 (16.6–4325.6) | 0.18 (0.05–0.64) |
Raw agreement | Cohen’s kappa | 95% CI | |
---|---|---|---|
Overall | 91.6% (164/179) | 0.73 | 0.60–0.86 |
Surgical candidates | 91.3% (21/23) | ||
Conservative care candidates | 92.6% (139/150) | ||
Uncertain | 66.7% (4/6) |