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Title:Diagnosticiranje poškodbe sprednje križne vezi s kliničnim testiranjem
Authors:ID Kandžič, Iris (Author)
ID Omejec, Gregor (Mentor) More about this mentor... New window
Files:.pdf 2116$$diplomska_naloga_kandzic_-_vis_removed.pdf (833,75 KB)
MD5: 4AD19E753D8AE56081F0C62A1BB8DB0F
 
Language:Slovenian
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA
Abstract:Poškodba SKV je pogosta ortopedska poškodba, katere incidenca se kljub preventivnim programom povečuje, zaradi pogostosti pa se v zdravstveni stroki pojavlja želja po hitrejšem in cenejšem načinu diagnosticiranja poškodbe. Namen diplomske naloge je bil pregledati literaturo o diagnostični vrednosti kliničnih testov pri sumu na poškodbo SKV. Cilj naloge je bil ugotoviti občutljivost, specifičnost, diagnostično zanesljivost ter pozitivno in negativno napovedno vrednost nekaterih najpogosteje uporabljenih kliničnih testov pri sumu na poškodbo SKV (Lachmanov test, sprednji predalčni test, pivot shift test in lever sign test) in rezultate primerjati z zlatim standardom (MR in diagnostična artroskopija). Na osnovi predhodnega pregleda literature smo si zastavili hipotezo H1, ki pravi, da imajo klinični testi pri sumu na poškodbo SKV visoko diagnostično zanesljivost, in hipotezo H2, ki pravi, da so rezultati testov, izvedenih med anestezijo, boljši od rezultatov, dobljenih pri testiranju zavestnega pacienta. V pregled je vključenih 12 študij, po pregledu katerih lahko delno potrdimo hipotezo H1, saj imajo testi pri enostavnejših primerih poškodb visoko diagnostično zanesljivost, manj zanesljivi pa so pri akutnih poškodbah, kjer bolečina in oteklina omejujeta izvedbo kliničnih testov, ter pri kompleksnih poškodbah, kjer je poškodovanih več sosednjih struktur in izolirano testiranje SKV ni zadostno. Glede na študije lahko potrdimo hipotezo H2, saj so vse primerjave testiranja pri zavesti in med anestezijo imele boljše rezultate v prid testiranju med anestezijo. Prednost testiranja med anestezijo se pokaže predvsem v tem, da pri močni fleksiji kolena pacient testiranja ne omejuje z mišičnimi kontrakcijami, ki bi jih sprožila bolečina. Kljub temu da so testi poznani in uveljavljeni, pa primanjkuje študij, ki bi definirale situacije, kjer bi jih lahko opolnomočili za diagnosticiranje poškodbe SKV. Take študije bi obsegale definirane statistične parametre testov, poenotene vključitvene in izključitvene kriterije ter demografsko reprezentativen vzorec.
Keywords:Sprednja križna vez, poškodba, diagnostična vrednost, klinično testiranje, slikovna diagnostika.
Year of publishing:2024
PID:20.500.12556/ReVIS-10545 New window
COBISS.SI-ID:197245699 New window
Publication date in ReVIS:21.05.2024
Views:644
Downloads:37
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Secondary language

Language:English
Title:Usage of Clinical Examination in Diagnosis of Anterior Cruciate Ligament Rupture
Abstract:The injury of the ACL is a common orthopedic injury, the incidence of which is increasing despite preventive programs, leading to a desire in the healthcare system for a faster and cheaper way of diagnosing the injury. The aim of this thesis was to review the literature on the diagnostic value of clinical tests for suspected ACL injury. The objective of the study was to determine the sesitivity, specificity, diagnostic accuracy and positive and negative predictive value of some of the most commonly used clinical tests foor suspected ACL injury (Lachman test, anterior drawer test, pivot shift test, and lever sign test) and compare the results with the golden standard (MRI and diagnostic arthroscopy). Based on the preliminary literature review, we formulated hypotheses H1, stating that clinical tests for suspected ACL injury have high diagnostic reliability, and H2, suggesting that the results of tests performed under anesthesia are better than those obtained from conscious patients. The review included 12 studies, and upon review, we could partially confirm hypothesis H1, as the tests showed high diagnostic reliability in simpler simpler cases of injury but were less reliable in acute injuries where pain and swelling limited the performance of clinical tests and in complex injuries where multiple adjacent structures were injured therefore isolated testing of the ACL was insufficient. According to the studies, we could confirm H2, as all comparisons between testing under consciousness and under anesthesia yielded better results in favor of testing under anesthesia. The advantage of testing under anesthesia is primarily shown when it comes to strong knee flexion, when patient does not restrict the testing with muscle contractions triggered by pain. Despite the tests being well-known and established, there is a lack of studies defining situations in which they could be empowered for diagnosing ACL injury. Such studies would include defined statistical parameters of the tests, standardized inclusion and exclusion criteria and a demographically representative sample.
Keywords:Anterior cruciate ligament, injury, diagnostic accuracy, clinical examination, diagnostic imaging.


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