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Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs

Artikel i vetenskaplig tidskrift
Författare Annelie Gutke
E. R. Hansson
G. Zetherstrom
Hans-Christian Östgaard
Publicerad i European Spine Journal
Volym 18
Nummer/häfte 7
Sidor 1008-12
ISSN 0940-6719
Publiceringsår 2009
Publicerad vid
Sidor 1008-12
Språk en
Ämnesord Adult, Aged, Diagnosis, Differential, False Positive Reactions, Female, Humans, Intervertebral Disk/innervation/pathology/physiopathology, Intervertebral Disk Displacement/complications/*diagnosis/physiopathology, Lumbar Vertebrae/pathology/*physiopathology, Male, Middle Aged, Neurologic Examination, Pain Measurement/*methods, Pelvic Pain/*diagnosis/etiology/physiopathology, Pelvis/pathology/*physiopathology, Predictive Value of Tests, Reproducibility of Results, Sex Characteristics, Young Adult
Ämneskategorier Ortopedi

Sammanfattning

The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.

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