Back Pain ‐Inducing Test, a novel and sensitive screening test for painful osteoporotic vertebral fractures: A prospective clinical study

ABSTRACTTo detect painful vertebral fractures (VFs) in back pain populations at risk of osteoporosis, we designed a physical examination test (the Back Pain ‐Inducing Test (BPIT)) that included three movements: lying supine, rolling over, and sitting up. If back pain is induced during any of these movements, the result is defined as positive, thereby establishing a presumptive diagnosis of painful VFs. Pain severity is quantified using a self‐report ed numerical rating scale (NRS). The presence or absence of painful VFs is verified by whole‐spine magnetic resonance imaging (MRI), the gold standard for final diagnosis. According to the standards for reporting diagnostic accuracy, a real‐world, prospective and observational study was performe d on 510 back pain patients (enrolled from a single institute) at risk of osteoporosis. The sensitivity, specificity, and accuracy of the BPIT for identifying painful VFs were 99.1% (95% confidence interval [CI], 97.5%–99.8%), 67.9% (95% CI, 60.4%–74.5%), and 89.0%, respectively. The positive an d negative predictive values were 86.6% (95% CI, 82.9%–89.6%) and 97.4% (95% CI, 92.6%–99.3%), respectively. Cutoff NRS scores for lying supine, rolling over, and sitting up were 3, 0, and 2, respectively. The corresponding area under the receiver operating characteristic curves (AUROCs) of each movement was 0.898 (95% CI, 0.868–0.922), 0.884 (95% CI, 0.854–0.911), and 0.910 (95% CI, 0.882–0.933), respectively. Although the hi...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research