ArticlePloS one2018
Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- The diagnostic accuracy of clinical tests for anterior cruciate ligament tears are comparable but the Lachman test has been previously overestimated: a systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Evaluating the diagnostic pathway for acute ACL injuries in trauma centres: a systematic review.BMC musculoskeletal disorders · 2022Pooled it
- Don't take their word for it: Investigating the diagnostic accuracy of history elements for anterior cruciate ligament tears.Journal of experimental orthopaedics · 2025Article
- [Value of Clinical Tests in Diagnosing Anterior Cruciate Ligament Tears: What Is New?]Revista brasileira de ortopedia · 2025Article
- Value of Clinical Tests in Diagnosing Anterior Cruciate Ligament Tears: What Is New?Revista brasileira de ortopedia · 2025Article
- The Lever Sign Test Demonstrates Limited Clinical Utility for Diagnosing Full-Thickness Anterior Cruciate Ligament Tears After a Traumatic Knee Injury.Orthopaedic journal of sports medicine · 2025Article
- Digital hand-held arthrometry is a reliable and accurate adjunct for diagnosing acute anterior cruciate ligament tears.Journal of experimental orthopaedics · 2025Article
- The Cambridge Knee Injury Tool (CamKIT): a clinical prediction tool for acute soft tissue knee injuries.BMJ open sport & exercise medicine · 2025Article
- Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review.Cureus · 2024Review
- Anterior Cruciate Ligament Injury among Patients with Knee Injury Visiting the Out-patient Department of Orthopaedics of a Tertiary Care Centre: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2022Article
- Anterior cruciate ligament reconstruction related complications: 2D and 3D high-resolution magnetic resonance imaging evaluation.Skeletal radiology · 2022Review
- Higher psychological distress in patients seeking care for a knee disorder is associated with diagnostic discordance between health care providers: a secondary analysis of a diagnostic concordance study.BMC musculoskeletal disorders · 2021Article
- Towards improving the identification of anterior cruciate ligament tears in primary point-of-care settings.BMC musculoskeletal disorders · 2020Article
- Clinical Value of an Acute Popping Sensation in Throwing Athletes With Medial Elbow Pain for Ulnar Collateral Ligament Injury.Orthopaedic journal of sports medicine · 2020Article
- Higher order thinking about differential diagnosis.Brazilian journal of physical therapyReview
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears.
designProspective diagnostic study. SETTINGS: Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling.
participantsConsecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2).
interventionsNot applicable.
main outcome measuresHistory elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated.
resultsForty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24).
conclusionDiagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders.
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