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Tuning Fork Test

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Other Names

Demonstration of the tuning fork test on the medial tibia[1]
  • Fork Test
  • Tuning Fork Test

Purpose

  • Detect source of pain, considering stress fracture

Description

  • Patient is seated or supine
  • The examiner places an actively vibrating tuning fork (typically 128 hertz) on the suspected injury
  • Positive test
    • Reproduction or worsening of patients pain

Pathology


Evidence

Stress Fracture in General

  • Schneiders et al[2]
    • Sensitivity: 35-92%
    • Specificity: 19-83%
    • LR+: 0.6 to 3.0
    • LR-: 0.4 to 1.6
    • PPD: 88%
    • NPD: 46%

Tibial Stress Fracture

  • Rosenthal et al[1]
    • Sensitivity: 5.7%
    • Specificity: 90.6%
    • PPV: 40.6%
    • NPV: 46.8%
    • PLR: 0.61
    • NLR: 1.04
    • Overall Accuracy: 46%

See Also


References

  1. 1.0 1.1 Rosenthal, Michael D., Mitchell J. Rauh, and James E. Cowan. "Prospective Assessment of Clinical Tests Used to Evaluate Tibial Stress Fracture." Orthopaedic Journal of Sports Medicine 10.9 (2022): 23259671221122356.
  2. Schneiders AG, Sullivan SJ, Hendrick PA, Hones BD, McMaster AR, Sugden BA, Tomlinson C. The ability of clinical tests to diagnose stress fractures: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2012 Sep;42(9):760-71. doi: 10.2519/jospt.2012.4000. Epub 2012 Jul 19.
Created by:
John Kiel on 4 April 2021 18:09:42
Authors:
Last edited:
25 May 2023 07:19:50
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