Evidence based diagnostics of musculoskeletal disorders in primary care

This chapter covers all elements of the validity of diagnostic tests relevant for physiotherapists whenever one reads a research paper, or searches the literature for clinical relevant diagnostic tools necessary to set a diagnosis or develop a treatment plan. In this chapter I explain the different forms of validity, such as sensitivity, specificity and predictive value. Furthermore, I explain concepts such as a likelihood ratio, diagnostic odds ratios and ROC-curves (receiver operator curves), although these are more relevant for research than clinical practice.

This chapter covers all aspects of reproducibility of diagnostic tests relevant for physiotherapists in daily practice. In daily practice knowledge about reproducibility of tests is relevant, especially when one reads a research paper, or searches the literature for clinical relevant diagnostic tools to tackle a clinical problem. I explain different elements of reproducibility, such as agreement, Kappa and correlation coefficients as well as the interpretation of these concepts.

Based on a case study, this chapter discusses the differences between research on individual diagnostic tests (classic test research) and the development of clinical prediction models. Depending on the outcome of interest (diagnosis, prognosis or treatment option), there are different prediction models, and also the interpretation of the results differs.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with low back pain is consulting him/her. The chapter starts with general information of low back pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with low back pain. As this chapter is the first of all eight chapters we will discuss some issues more explicit compared to the other chapters.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with hip pain is consulting him/her. The chapter starts with general information of hip pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with hip pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with knee pain is consulting him/her. The chapter starts with general information of knee pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with knee pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with ankle or foot pain is consulting him/her. The chapter starts with general information of ankle and foot pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with ankle and foot pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with neck pain is consulting him/her. The chapter starts with general information of neck pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with neck pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with shoulder pain is consulting him/her. The chapter starts with general information of shoulder pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with shoulder pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with elbow pain is consulting him/her. The chapter starts with general information of elbow pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with elbow pain.

Based on a case study, in this chapter I discuss the clinical reasoning of a physiotherapist when a patient with wrist or hand pain is consulting him/her. The chapter starts with general information of wrist and hand pain, known risk factors and prognosis. In addition, I discuss the existing evidence on validity of history taking, physical examination, specific tests if necessary and diagnostic imaging and their value within the diagnostic process of subgroups of patients with wrist and hand pain.