Some targeted tests for soft tissue injuries to the knee can be highly sensitive and specific and are therefore valuable, noninvasive, diagnostic tools. Testing on the ankle is less sensitive, but it can be useful in combination with other physical examination findings.
Physical examination has a time-honoured role in the evaluation of sports injuries, often providing the basis of a diagnosis. The self-limiting nature of many soft tissue injuries, and their response to conservative interventions, means that there is often no justification for complex imaging or surgical intervention. Consequently, for many sports injuries there is no gold standard against which to determine the sensitivity, specificity and accuracy of a particular physical examination technique. The other important characteristic of any diagnostic test, including physical examination, is reliability. This measures the degree to which either the same examiner on different occasions or different examiners make the same finding.
This is the first of two articles that will consider several targeted tests that either have known reliability, sensitivity, specificity or accuracy or have apparent clinical utility. This part will consider general principles in assessing sports injuries and feature the knee and ankle, and part 2, in the following issue, will discuss specific tests of the shoulder.