Validation of tuning fork test in stress fractures and its comparison with radionuclide bone scan | [Journal of Ayub Medical College • 2012]

Author(s):

1. Syeda Tatheer Fatima: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad,Pakistan

2. Asif Jeilani: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad,Pakistan

3. Mazhar-ud-Duha: Women Medical College Abbottabad, Pakistan

4. Nadeem Zia Abbasi: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad, Pakistan

5. Amjad Aziz Khan: Dera Ismail Khan Institute of Nuclear Medicine and Radiotherapy, DI Khan, Pakistan

6. Kamran Khan: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad, Pakistan

7. Abdul Samad Sheikh: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad, Pakistan

8. Furqan Ali: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad, Pakistan

9. Khalid Hussain Memon: Department of Nuclear Medicine, Institute of Nuclear Medicine,Oncology and Radiotherapy, Abbottabad, Pakistan

Abstract:

Background: Stress fractures are quite common both in athletes and military recruits. The purpose of the study was to evaluate the efficacy of tuning fork in stress fractures by comparing it with three phase bone scan. Methods: The current study examined 55 subjects whose age ranged 18-28 years. X-rays of all the subjects were unremarkable. After history and clinical examination tuning fork test (TFT) was performed on each case by placing 128 Hertz vibrating tuning fork on the site of pain (underlying bony surface) of tibia or fibula. Each case was scanned using triple phase bone scintigraphy. Results: Fiftyfive patients had a total of 67 stress fractures, out of which 53 were picked up by TFT. Sensitivity of TFT was found to be 79% and specificity of 63%. Positive and negative predictive values were 88% and 46% respectively. Conclusion: Tuning fork test is a simple and easy approach of diagnosing stress fractures which can be performed even by athletics and military trainers. Management should be initiated in patients who have history of stress related below-knee pain and positive tuning fork test without waiting for bone scintigraphy. For complicated cases the bone scan is the gold standard for diagnosis.

Page(s): 3-4

DOI: DOI not available

Published: Journal: Journal of Ayub Medical College, Volume: 24, Issue: 3--4, Year: 2012

Keywords:

stress fracture , bone scan , tuning fork test

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