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Journal articles on the topic 'Pain provocation test'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Singh, Vijay. "Systematic Review of Thoracic Discography as a Diagnostic Test for Chronic Spinal Pain." October 2008 5;11, no. 10;5 (October 14, 2008): 631–42. http://dx.doi.org/10.36076/ppj.2008/11/631.

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Background: Even though the prevalence of thoracic pain has been reported to be 15% of the general population and up to 22% of the population in interventional pain management settings, the role of thoracic discs as a cause of chronic thoracic and extrathoracic pain has not been well researched. The intervertebral discs, zygapophysial or facet joints, and other structures including the costovertebral and costotransverse joints have been identified as a source of thoracic pain. Objective: To systematically assess the quality of clinical studies evaluating the diagnostic accuracy of provocation thoracic discography. Study Design: A systematic review of provocation thoracic discography. Methods: A systematic review of the literature was performed to assess the diagnostic accuracy of thoracic discography with respect to chronic, function limiting, thoracic or extrathoracic pain. Studies meeting the Agency for Healthcare Research and Quality (AHRQ) methodologic quality criteria with scores of 50 or higher were included for the assessment of the level of evidence. Level of evidence was based on the United States Preventive Services Task Force (USPSTF) criteria for the assessment of accuracy of diagnostic studies. Based on the level of evidence, recommendations were made according to Guyatt et al’s criteria. Results: The clinical value of thoracic provocation discography is limited (Level II-3) with 2C/weak recommendation derived from low quality or very low quality evidence indicating that other alternatives may be equally reasonable. Conclusion: Based on the available evidence for this systematic review, thoracic provocation discography is provided with a weak recommendation for the diagnosis of discogenic pain in the thoracic spine, if conservative management has failed. This is qualified by the need to appropriately evaluate and diagnose other causes of chronic thoracic pain including pain originating from thoracic facet joints. Key words: Thoracic pain, chest wall pain, intervertebral disc, thoracic intervertebral disc, facet joint, thoracic disc herniation, discogenic pain, lumbar provocation discography, cervical provocation discography, thoracic provocation discography, false-positive response, diagnostic accuracy

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2

Mimori, K., T. Nakagawa, T. Sugihara, and K. Shinomiya. "44 Pain provocation test for superior labral tear." Journal of Shoulder and Elbow Surgery 7, no. 3 (May 1998): 333. http://dx.doi.org/10.1016/s1058-2746(98)90143-4.

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3

Vanharanta, H., and M. Yrjämä. "Vibration pain provocation as a spine diagnostic test." Pathophysiology 5 (June 1998): 265. http://dx.doi.org/10.1016/s0928-4680(98)81331-x.

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4

Dutau, G. "Allergies alimentaires et alternatives diagnostiques : test de provocation labial, test de provocation oral." Revue Française d'Allergologie et d'Immunologie Clinique 40, no. 7 (November 2000): 728–41. http://dx.doi.org/10.1016/s0335-7457(00)80080-5.

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5

Líška, D., R. Zelník, and N. Hegedüšová. "Clinical examination of the sacroiliac joint." Journal of Orthopaedics, Trauma and Rehabilitation 28 (January 1, 2021): 221049172110007. http://dx.doi.org/10.1177/22104917211000755.

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Introduction: Sacroiliac joint (SIJ) can be a nociceptive source of the pain in lower back. Clinical diagnosis of SIJ pain remains yet problematic. The cause of SIJ pain is multifactorial. The pain may be a result of an inflammatory disease, arthrosis, traumatic injury, infectious process or overload. The potential role in SIJ examination have pain provocation tests. Objective: To review and further discuss the validity of some of the mostly used clinical provocation tests such as Distraction test, Thigh Thrust test, Compression test, Sacral Thrust test, Patrick’s (FABER), Gaenslen’s test, Standing Flexion Test, Gillet Test and Shimpi Prone test. Method: A literature search was conducted using PubMed. Reviewed were studies between 2005 and 2020 in English, Slovak and Czech with keywords: sacroiliac joint, sacroiliac assessment, provocation tests. The methodology of studies was not considered. Discussion: It is challenging to determine whether SIJ is the actual source of the pain by using only one of the provocation tests. Therefore, it is beneficial to combine more compression tests, what will also increase the validity of testing. Other widely used SIJ tests are palpation test, however their validity is poor.

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Manchikanti, Laxmaiah. "Systematic Review of Lumbar Discography as a Diagnostic Test for Chronic Low Back Pain." Pain Physician 3;12, no. 3;5 (May 14, 2009): 541–99. http://dx.doi.org/10.36076/ppj.2009/12/541.

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Background: The intervertebral disc has been implicated as an etiology of chronic lumbar spine pain based on clinical, basic science, and epidemiological research. However, there is lack of consensus regarding the diagnosis and treatment of intervertebral disc disorders. Based on controlled evaluations, the lumbar intervertebral discs have been shown to be sources of chronic back pain without disc herniation in 26% to 39%. Lumbar provocation discography, which includes disc stimulation and morphological evaluation, is often used to distinguish a painful disc from other potential sources of pain. Despite the extensive literature, controversy continues about provocation lumbar discography. Study Design: A systematic review of the lumbar provocation discography literature. Objectives: To systematically assess the diagnostic accuracy of lumbar discography. Methods: A systematic review of the literature was performed to assess the diagnostic accuracy of lumbar discography with respect to chronic low back pain. Study inclusion/exclusion criteria were based on International Association for the Study of Pain (IASP) standards with pain provocation and determination of controlled discs. Selected studies were then subjected to a rating instrument for diagnostic accuracy studies. Specific data were then culled from these studies and tabulated. Quality of evidence was assessed using modified Agency for Healthcare Research and Quality (AHRQ) diagnostic accuracy evaluation. Studies meeting methodologic quality criteria scores of 50 or higher were included in the assessment of the level of evidence. Qualitative analysis was conducted using 5 levels of evidence, ranging from Level I to III, with 3 subcategories in Level II. The rating scheme was modified to evaluate the diagnostic accuracy. Results: Based on a modified U.S. Preventive Services Task Force (USPSTF) level of evidence criteria, this systematic review indicates the strength of evidence as Level II-2 for the diagnostic accuracy of lumbar provocation discography utilizing IASP criteria. Limitations: Limitations include a paucity of literature, poor methodologic quality, and very few studies performed utilizing IASP criteria. Conclusion: Based on the current systematic review, lumbar provocation discography performed according to the IASP criteria with control disc (s) with minimum pain intensity of 7 of 10, or at least 70% reproduction of worst pain (i.e. worst spontaneous pain of 7 = 7 x 70% = 5) may be a useful tool for evaluating chronic lumbar discogenic pain. Discography is an important imaging and pain evaluation tool in identifying a subset of patients with chronic low back pain secondary to intervertebral disc disorders. Key words: Chronic low back pain, lumbar intervertebral disc, lumbar discography, provocation discography, pain generator, false-positives, diagnostic accuracy, sensitivity, specificity

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7

Östgaard, H. C., G. Zetherström, and E. Roos-Hansson. "The posterior pelvic pain provocation test in pregnant women." European Spine Journal 3, no. 5 (October 1994): 258–60. http://dx.doi.org/10.1007/bf02226575.

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8

Smythe, A., A. W. Majeed, M. Fitzhenry, and A. G. Johnson. "A requiem for the cholecystokinin provocation test?" Gut 43, no. 4 (October 1, 1998): 571–74. http://dx.doi.org/10.1136/gut.43.4.571.

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Background—The cholecystokinin provocation test (CCKPT) has been claimed to predict a better symptomatic result after cholecystectomy in patients with acalculous biliary pain.Aims—To examine the predictive value of the CCKPT for symptom relief after cholecystectomy in both CCKPT positive and negative patients.Patients and methods—Fifty eight patients with acalculous biliary pain underwent CCKPT with serial ultrasound gall bladder volumetry. CCKPT positive patients were offered cholecystectomy; negative patients were reassessed and were offered a cholecystectomy if symptoms persisted. Six months after cholecystectomy, the CCKPT was repeated.Results—Of 32 CCKPT positive patients, 27 underwent cholecystectomy and of these, 18 (67%) became symptom-free. Postoperatively, 20 of 25 patients converted to CCKPT negative but five remained CCKPT positive and were symptomatic. Of the 26 CCKPT negative patients, nine became symptom-free without cholecystectomy; six of 14 (42.8%) patients undergoing cholecystectomy became asymptomatic and remained CCKPT negative. Cholecystectomy seemed to reduce symptoms in both groups, but there was no significant difference in the symptomatic outcome between preoperative CCKPT positive and negative patients.Conclusions—In this study, cholecystokinin provocation testing did not predict symptomatic benefit from cholecystectomy and we suggest it should no longer be used in the evaluation of patients with acalculous biliary pain.

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9

Singh, Vijay. "An Update of the Appraisal of the Accuracy of Thoracic Discography as a Diagnostic Test for Chronic Spinal Pain." Pain Physician 6;15, no. 6;12 (September 14, 2012): E757—E776. http://dx.doi.org/10.36076/ppj.2012/15/e757.

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Background: Even though the prevalence of thoracic pain has been reported to be 13% of the general population and up to 22% of the population in interventional pain management settings, the role of thoracic discs as a cause of chronic thoracic and extrathoracic pain has not been well studied. The intervertebral discs, zygapophysial or facet joints, and other structures including the costovertebral and costotransverse joints have been identified as a source of thoracic pain. Study Design: A systematic review of provocation thoracic discography. Objective: To systematically assess and update the quality of clinical studies evaluating the diagnostic accuracy of provocation thoracic discography. Methods: A systematic review of the literature was performed to assess the diagnostic accuracy of thoracic discography with respect to chronic, function limiting, thoracic or extrathoracic pain. The available literature on thoracic discography was reviewed. A methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). The level of evidence was classified as good, fair, and limited (or poor) based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. Results: The evidence and clinical value of thoracic provocation discography is limited (poor) with a paucity of evidence, with only 2 studies meeting inclusion criteria. Limitations: The limitation of this study continues to be the paucity of literature. Conclusion: Based on the available evidence for this systematic review, due to limited evidence, thoracic provocation discography is rarely recommended for the diagnosis of discogenic pain in the thoracic spine, if conservative management has failed and facet joint pain has been excluded. Key words: Thoracic pain, chest wall pain, intervertebral disc, thoracic intervertebral disc, thoracic disc herniation, discogenic pain, thoracic provocation discography, falsepositive response, diagnostic accuracy

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d’Hemecourt, Pierre, Dai Sugimoto, Maxwell McKee-Proctor, and Andrea Stracciolini. "SENSITIVITY AND SPECIFICITY OF PHYSICAL EXAMINATION TESTS FOR SACROILIAC PAIN IN THE ADOLESCENT AND YOUNG ATHLETES." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (March 1, 2019): 2325967119S0006. http://dx.doi.org/10.1177/2325967119s00066.

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BACKGROUND: Low back pain is a common clinical complaint for young athletes. Making the diagnosis of sacroiliac (SI) pain is often challenging, as the clinical diagnosis is challenging with many non-specific physical examination findings. Previous research has attempted to identify the most accurate physical examination tests; however, the findings were limited in adult populations [1]. The most accurate physical examination test has not been established in pediatric, adolescent, and young adult patients with SI pain. Therefore, the purpose of this study was to identify the sensitivity and specificity of SI physical examination tests in order to diagnose more accurately SI joint pathology in pediatric, adolescent, young adult athletes. METHODS: A prospective study design was used. Pediatric, adolescent, and young adults presenting to the Sports Medicine clinic with low back pain underwent a series of physical examination tests for SI pathology. The physical examination tests for SI included: 1) pelvic distraction, 2) thigh thrust, 3) figure of four, 4) flexion-abduction-external rotation (FABER), 5) pelvic compression, 6) sacral torque, 7) sacral compression, 8) Gaenslen’s test, and 9) Stinchfield’s test. All study patients self-reported pain levels on a Visual Analog Scale (VAS) from 0 to 100 following each test. All study patients were then treated with, an ultrasound-guided injection of anesthetic and corticosteroid into the SI joint. To evaluate accuracy of each of the 9 provocation tests, two by two (2 x 2) contingency tables were developed by positive (+) or negative (-) response to SI special provocation test prior to SI injection and (+) or (-) response to anesthetic and corticosteroid following SI injection. Those who demonstrated 50% or greater pain alleviation immediately following injection were diagnosed with an SI pathology, and thus a (+) response. Based on the 2 x 2 contingency tables, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, and accuracy of each provocation test were calculated. RESULTS: A total of 69 participants (age: 19.5 ± 5.5 years old, age range: 13 - 52, sex: 11 males and 58 females) were tested. There were 14 participants who had complaints of bilateral SI symptoms. Thus, right and left sides were treated separately, which resulted in a total of 83 data points. Table 1 summarizes the outcomes of each provocation test. The sacral torque maneuver was found to be the most sensitive (92.3%) and the most accurate (74.4%) in terms of diagnosing SI joint pathology. All maneuvers besides the Gaenslen test had over 50% sensitivity. However, accuracy of the distraction, Gaenslen, and Stinchfield maneuvers were under 50%. CONCLUSION/SIGNIFICANCE: In the pediatric, adolescent, and young adult populations, the leading three most sensitive clinical provocation tests for reproducing sacroiliac pain were the sacral torque, thigh thrust, and sacral compression tests. These three tests also demonstrate relatively high accuracy (>60%). These findings support the clinical utility of selected physical examination tests for accurately diagnosing SI joint pathology. Due to the relatively high number of false positives and false negatives, it is clear that more research are warranted to optimize these maneuvers before they can be considered as a standalone clinical tool. However, the implications of these results are encouraging and justify exploring the utility of provocative maneuvers of the SI joint in greater detail. [Table: see text]

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Ando, Fukiko, and Kazutomo Ohashi. "Using the posterior pelvic pain provocation test in pregnant Japanese women." Nursing & Health Sciences 11, no. 1 (February 10, 2009): 3–9. http://dx.doi.org/10.1111/j.1442-2018.2008.00406.x.

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12

Awaya, Toru, Masao Moroi, Fuminori Nakamura, Satoru Toi, Momoko Wakiya, Yoshinari Enomoto, Taeko Kunimasa, and Masato Nakamura. "A Possibility of Vasospastic Angina after mRNA COVID-19 Vaccination." Vaccines 10, no. 12 (November 24, 2022): 1998. http://dx.doi.org/10.3390/vaccines10121998.

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We report a case of vasospastic angina (VSA) following COVID-19 mRNA vaccination. Despite the widespread occurrence of myocarditis, there have been few reports of post-vaccinal VSA. A 41-year-old male patient was referred for chest pain at rest following mRNA vaccination; he had never experienced chest pain prior to vaccination. He was diagnosed by an acetylcholine (Ach) provocation test that showed multivessel vasospasm. After the initiation of treatment with a calcium channel blocker and nitrate, no further exacerbation of chest pain was observed. To our knowledge, this constitutes the first reported case of VSA proven by Ach provocation test after COVID-19 vaccination. The vaccination may increase coronary artery spasticity. VSA should be ruled out in post-vaccine new onset resting chest pain.

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13

Chiambaretta, F., J. L. Fauquert, and D. Rigal. "Le test de provocation conjonctivale : quand et comment ?" Revue Française d'Allergologie et d'Immunologie Clinique 45, no. 3 (April 2005): 234–36. http://dx.doi.org/10.1016/j.allerg.2005.02.018.

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14

Telli, Hilal. "The Validity and Reliability of Provocation Tests in the Diagnosis of Sacroiliac Joint Dysfunction." January 2018 1, no. 21;1 (July 15, 2018): E367—E376. http://dx.doi.org/10.36076/ppj.2018.4.e367.

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Background: Although sacroiliac joint dysfunction (SIJD) is generally regarded as a source of lumbar pain, its anatomical position and the absence of a diagnostic ‘gold standard’ lead to difficulties at examination and differential diagnosis. However, since sacroiliac (SI) joint blocks only provide information about pathologies of joint origin and since SIJD developing secondary to pathologies in structures around the joint can be missed. Provocation and palpation tests also need to be used in diagnosis. Objectives: The purpose of this study was to examine the reliability of clinical examination and provocation tests used in the diagnosis of SIJD. Study Design: Retrospective analysis of prospectively collected data. Setting: Outpatient physical medicine and rehabilitation clinic. Methods: One hundred and seventeen patients presenting with lumbar and/or leg pain and diagnosed with SIJD through clinical evaluation were included in the study. Range of lumbar joint movement, pain location and specific tests used in the diagnosis of SIJD were evaluated. Positivity in 3 out of 6 provocation tests was adopted as the criterion. Results: 75.2% of patients were female and 24.8% were male. Mean age was 46.41 ± 10.45 years. A higher level of females was determined in ender distribution. SIJD was determined on the right in 52.6% of patients and on the left in 47.4%. When SI joint provocation tests were analyzed individually, the highest positivity, in 91.4% patients diagnosed with SIJD, was in the FABER test. The lowest positivity, in 56.4% of patients, was determined in the Ganslen test. The same patients were assessed by the same clinician at 2 different times. In these data, the simple consistence, kappa and PABAK coefficient values of all tests were close to 1 and indicating good agreement. The thigh thrust (POSH) and sacral thrust tests exhibited very good agreement with a kappa coefficient of 0.90 and a PABAK coefficient of 0.92, while the FABER test exhibited good agreement with a kappa coefficient of 0.78 and a PABAK coefficient of 0.92. Limitation: Agreement between different observers was not evaluated, and also no comparison was performed with SI joint injection, regarded as a widely used diagnostic technique. Conclusion: The anatomical position of the SI joint and the lack of a diagnostic ‘gold standard’ make the examination and diagnosis of SIJD difficult. Most SI joint clinical tests have limited reliability and validity on their own, while a multitest regimen consisting of SI joint pain provocation tests is a reliable method, and these tests can be used instead of unnecessary invasive diagnostic SI joint procedures. Key words: Dysfunction, lumbar, sacroiliac joint, provocation test, sacroiliac joint pain, pain pattern

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Manchikanti, Laxmaiah. "Systematic Review of Cervical Discography as a Diagnostic Test for Chronic Spinal Pain." Pain Physician 2;12, no. 2;3 (March 14, 2009): 305–21. http://dx.doi.org/10.36076/ppj.2009/12/305.

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Background: Chronic neck pain represents a significant public health problem. Despite high prevalence rates, there is a lack of consensus regarding the causes or treatments for this condition. Based on controlled evaluations, the cervical intervertebral discs, facet joints, and atlantoaxial joints have all been implicated as pain generators. Cervical provocation discography, which includes disc stimulation and morphological evaluation, is often used to distinguish a painful disc from other potential sources of pain. Yet in the absence of validation and controlled outcome studies, the procedure remains mired in controversy. Study Design: A systematic review of the cervical discography literature. Objective: To evaluate the validity and usefulness of cervical provocation discography in managing and diagnosing discogenic pain by means of a systematic review. Methods: Following a comprehensive search of the literature, selected studies were subjected to a modified Agency for Healthcare Research and Quality (AHRQ) diagnostic accuracy evaluation. Qualitative analysis was conducted using 5 levels of evidence, ranging from Level I to III with 3 subcategories in Level II. The rating scheme was modified to evaluate the diagnostic accuracy. Results: A systematic review of the literature demonstrated that cervical discography plays a significant role in selecting surgical candidates and improving outcomes, despite concerns regarding the false-positive rate, lack of standardization, and assorted potential confounding factors. Based on the studies utilizing the International Association for the Study of Pain (IASP) criteria, the data show a prevalence rate ranging between 16% and 20%. Based on the 3 studies that utilized IASP criteria during the performance of cervical discography, the evidence derived from studies evaluating the diagnostic validity of the procedure, the indicated level of evidence is Level II-2 based on modified U.S. Preventive Services Task Force (USPSTF) criteria. Limitations: Limitations include a paucity of literature, poor methodologic quality, and very few studies performed utilizing IASP criteria. Conclusion: Cervical discography performed according to the IASP criteria may be a useful tool for evaluating chronic cervical pain, without disc herniation or radiculitis. Based on a modified AHRQ accuracy evaluation and USPSTF level of evidence criteria, this systematic review indicates the strength of evidence as Level II-2 for diagnostic accuracy of cervical discography. Key words: Neck pain, headache, cervical discogenic pain, cervical intervertebral disc, cervical provocation discography, false-positive rates, diagnostic accuracy, outcomes, cervical facet joint pain, controlled diagnostic blocks

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Mimori, Kou, Takeshi Muneta, Teruhiko Nakagawa, and Kenichi Shinomiya. "A New Pain Provocation Test for Superior Labral Tears of the Shoulder." American Journal of Sports Medicine 27, no. 2 (March 1999): 137–42. http://dx.doi.org/10.1177/03635465990270020401.

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Dutau, G., and P. Scheinmann. "Test de provocation orale en allergie alimentaire: l'indispensable clarification." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 6 (October 2006): 602–3. http://dx.doi.org/10.1016/j.allerg.2006.10.002.

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Deschildre, A., C. Bonnel, C. Thumerelle, and C. Santos. "Quelles sont les indications d’un test de provocation oral ?" Revue Française d'Allergologie et d'Immunologie Clinique 47, no. 3 (April 2007): 190–92. http://dx.doi.org/10.1016/j.allerg.2007.01.014.

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Iwata, Eiichiro, Hideki Shigematsu, Kazuya Inoue, Takuya Egawa, Yoshihiro Sakamoto, and Yasuhito Tanaka. "Muscle Weakness in the Empty and Full Can Tests Cannot Differentiate Rotator Cuff Tear from Cervical Spondylotic Amyotrophy: Pain Provocation is a Useful Finding." Open Orthopaedics Journal 11, no. 1 (September 30, 2017): 1081–86. http://dx.doi.org/10.2174/1874325001711011081.

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Purpose: Rotator cuff tears and cervical spondylotic amyotrophy (CSA) are often confused as the main symptom in those with difficulty in shoulder elevation. Empty and full can tests are frequently used for the clinical diagnosis of rotator cuff tears. The aim of the present study was to investigate whether the empty and full can test results can help differentiate rotator cuff tears from CSA. Methods: Twenty-seven consecutive patients with rotator cuff tears and 25 with CSA were enrolled. We prospectively performed empty and full can tests in patients with rotator cuff tears and CSA. The following signs were considered positive: (a) muscle weakness during the empty can test, (b) muscle weakness during the full can test, (c) pain provocation during the empty can test, and (d) pain provocation during the full can test. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of rotator cuff tears for each positive finding. Results: The sensitivity and specificity of each index were as follows (sensitivity, specificity, PPV, NPV): (a) 77.8%, 0%, 45.7%, 0%; (b) 66.7%, 4.0%, 42.9%, 10.0%; (c) 88.9%, 96.0%, 96.0%, 88.9%; and (d) 74.1%, 96.0%, 95.2%, 77.4%. There were significant differences for each index. Conclusion: Muscle weakness during the empty and full can tests was not useful in differentiating rotator cuff tears from CSA because of low specificity and PPV. However, pain provocation was useful in differentiating these two conditions because of high specificity and PPV.

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Oftedal, G., A. Straume, A. Johnsson, and LJ Stovner. "Mobile Phone Headache: A Double Blind, Sham-Controlled Provocation Study." Cephalalgia 27, no. 5 (May 2007): 447–55. http://dx.doi.org/10.1111/j.1468-2982.2007.01336.x.

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The objective was to test whether exposure to radio frequency (RF) fields from mobile phones may cause head pain or discomfort and whether it may influence physiological variables in individuals attributing symptoms to mobile phones, but not to electromagnetic fields in general. Seventeen eligible individuals, who experienced these symptoms in an open provocation test, took part in a double-blind, randomized provocation study with cross-over design. Sixty-five pairs of sham and mobile phone RF exposures were conducted. The increase in pain or discomfort (visual analogue scales) in RF sessions was 10.1 and in sham sessions 12.6 ( P = 0.30). Changes in heart rate or blood pressure were not related to the type of exposure ( P: 0.30-0.88). The study gave no evidence that RF fields from mobile phones may cause head pain or discomfort or influence physiological variables. The most likely reason for the symptoms is a nocebo effect.

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Gutke, Annelie, Eva Roos Hansson, Gunilla Zetherström, and Hans Christian Östgaard. "Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs." European Spine Journal 18, no. 7 (April 24, 2009): 1008–12. http://dx.doi.org/10.1007/s00586-009-1003-z.

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Bass, C., J. B. Chambers, and W. N. Gardner. "Hyperventilation provocation in patients with chest pain and a negative treadmill exercise test." Journal of Psychosomatic Research 35, no. 1 (January 1991): 83–89. http://dx.doi.org/10.1016/0022-3999(91)90009-d.

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Rio, Ebonie, Michael Girdwood, Jake Thomas, Christopher Garofalo, Lauren V. Fortington, and Sean Docking. "Pain mapping of the anterior knee: injured athletes know best." Scandinavian Journal of Pain 18, no. 3 (July 26, 2018): 409–16. http://dx.doi.org/10.1515/sjpain-2018-0046.

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Abstract Background and aims Research investigating differences in pain location and distribution across conditions is lacking. Mapping a patient’s pain may be a useful way of understanding differences in presentations, however the use of pain mapping during a pain provocation task has not been investigated. The aim of this study was to assess the reliability of patient and clinician rated pain maps during a pain provocation task for the anterior knee. Methods Participants were recruited from a larger study of professional Australian rules football players (n=17). Players were invited to participate if they reported a current or past history of patellar tendon pain. No clinical diagnosis was performed for this reliability study. Participants were asked to point on their own knee where they usually experienced pain, which was recorded by a clinician on a piloted photograph of the knee using an iPad. Participants then completed a single leg decline squat (SLDS), after which participants indicated where they experienced pain during the task with their finger, which was recorded by a clinician. Participants then recorded their own self-rated pain map. This process was repeated 10 min later. Pain maps were subjectively classified into categories of pain location and spread by two raters. Pain area was quantified by the number of pixels shaded. Intra- and inter-rater reliability (between participants and clinicians) were analysed for pain area, similarity of location as well as subjective classification. Results Test-retest reliability was good for participants (intraclass correlation coefficients [ICC]=0.81) but only fair for clinicians (ICC=0.47) for pain area. There was poor agreement between participants and clinicians for pain area (ICC=0.16) and similarity of location (Jaccard index=0.19). Clinicians had good inter- and intra-rater reliability of classification of pain spread (k=0.75 and 0.67). Conclusions Participant completed pain maps were more reliable than clinician pain maps. Clinicians were reliable at classifying pain based on location and type of spread. Implications Clinicians should ask patients to complete their own pain maps following a pain provocation test, to elicit the most reliable and consistent understanding of their pain perception.

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Leoni, Diego, Deborah Falla, Carolin Heitz, Gianpiero Capra, Ron Clijsen, Michele Egloff, Corrado Cescon, Jean-Pierre Baeyens, and Marco Barbero. "Test-retest Reliability in Reporting the Pain Induced by a Pain Provocation Test: Further Validation of a Novel Approach for Pain Drawing Acquisition and Analysis." Pain Practice 17, no. 2 (March 15, 2016): 176–84. http://dx.doi.org/10.1111/papr.12429.

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van der Heide, B., G. T. Allison, and M. Zusman. "Pain and muscular responses to a neural tissue provocation test in the upper limb." Manual Therapy 6, no. 3 (August 2001): 154–62. http://dx.doi.org/10.1054/math.2001.0406.

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Rathleff, Michael Skovdal, Sinead Holden, Kasper Krommes, Lukasz Winiarski, Per Hölmich, Tagrid Jamal Salim, and Kristian Thorborg. "The 45-second anterior knee pain provocation test: A quick test of knee pain and sporting function in 10–14-year-old adolescents with patellofemoral pain." Physical Therapy in Sport 53 (January 2022): 28–33. http://dx.doi.org/10.1016/j.ptsp.2021.11.002.

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Mallinson, Paul I., Charles R. Tapping, Richard Bartlett, and Paul Maliakal. "Factors that Affect the Efficacy of Fluoroscopically Guided Selective Spinal Nerve Root Block in the Treatment of Radicular Pain: A Prospective Cohort Study." Canadian Association of Radiologists Journal 64, no. 4 (November 2013): 370–75. http://dx.doi.org/10.1016/j.carj.2013.03.001.

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Aim The fluoroscopically guided selective nerve root block (SNRB) is being used increasingly as a therapy for radicular pain as well as a diagnostic tool. However, studies and the literature reviews have yet to reach a definite conclusion on the efficacy in this setting. Our aim was to prospectively investigate factors that may affect the success of this procedure. Materials and Methods A total of 301 treatment episodes with 283 patients were assessed over 25 months by patient questionnaire over a 7-day period. Changes in analgesic benefit over time, by operating consultant, referring specialty, spinal level, and the presence of periprocedural symptom provocation were evaluated. Statistical analysis was performed by using the χ2 test, Wilcoxon test, and Kruskal-Wallis rank sum test, and the asymptotic marginal-homogeneity test. P < .05 was considered significant. Results There was a statistically significant increase in pain relief over the 7 days after the procedure. Pain provocation during the procedure did not improve analgesic success. Cervical, lumbar, and sacral level procedures were equally efficacious. The specialist who referred the patient and the use of contrast to verify needle position during the procedure also did not affect the analgesic outcome. Overall, 69.1% of patients experienced some pain relief by day 7. Conclusion Analgesic success rates of selective nerve root blocks did not vary with spinal level, or use of contrast or periprocedural replication of symptoms, when using fluoroscopic guidance. Patients may expect a continued significant improvement in their symptoms for at least a week after the procedure.

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Drew, M. K., T. S. Palsson, M. Izumi, R. P. Hirata, G. Lovell, P. Chiarelli, P. G. Osmotherly, and T. Graven-Nielsen. "Resisted adduction in hip neutral is a superior provocation test to assess adductor longus pain: An experimental pain study." Scandinavian Journal of Medicine & Science in Sports 26, no. 8 (August 6, 2015): 967–74. http://dx.doi.org/10.1111/sms.12529.

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van der Heide, Brigitte, Claire Bourgoin, Georgina Eils, Bjorn Garnevall, and Marie Blackmore. "Test-Retest Reliability and Face Validity of a Modified Neural Tissue Provocation Test in Patients with Cervicobrachial Pain Syndrome." Journal of Manual & Manipulative Therapy 14, no. 1 (January 2006): 30–36. http://dx.doi.org/10.1179/106698106790820863.

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Park, Ji Young, Se Yeon Choi, Seung-Woon Rha, Byoung Geol Choi, Yung-Kyun Noh, and Yong Hoon Kim. "Sex Difference in Coronary Artery Spasm Tested by Intracoronary Acetylcholine Provocation Test in Patients with Nonobstructive Coronary Artery Disease." Journal of Interventional Cardiology 2022 (September 9, 2022): 1–10. http://dx.doi.org/10.1155/2022/5289776.

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Introduction. Cardiovascular diseases manifest differently in men and women. The purpose of this study is to compare the sex difference in the characteristics of coronary artery spasm (CAS) in patients with nonobstructive cardiovascular disease (NOCVD) and the clinical outcomes in accordance with sex in CAS patients. Methods. The study analysed 5,491 patients with NOCVD who underwent an acetylcholine provocation test from November 2004 to May 2014 for evaluation of chest pain. CAS was defined as greater than 70% of luminal narrowing of the artery during the acetylcholine provocation test. Results. The patients were divided into men (n = 2,506) and women (n = 2,985). Mean follow-up days were 1,218 ± 577 days. To adjust for confounding factors, the propensity score matching (PSM) analysis was performed in all patients and among the CAS patients. After PSM analysis, a total of 1,201 pairs in all patients and a total of 713 pairs in CAS patients were generated. In all patients, women showed significantly less incidence of CAS compared with men (62.3% vs 50.9%, P < 0.01 ). Myocardial bridge (MB) and moderate stenosis were less prevalent in women, while transient ST elevation and ischemic chest pain during provocation were more frequent in women. In CAS patients, men had a higher incidence of multivessel spasm than women (35.7% vs. 29.7%, P < 0.01 ). Old age, dyslipidemia, and MB were independent risk factors of CAS in both men and women. In CAS patients, there was no statistical differences for various individual and composite major outcomes up to five years in either men or women. In men with CAS, old age was a risk factor of a 5-year major adverse cardiac event (MACE), and moderate stenosis was a risk factor of both 5-year MACE and 5-year recurrent angina. In women with CAS, mild stenosis was a risk factor of 5-year MACE, while myocardial bridge was a risk factor of 5-year recurrent angina. Conclusions. In this study, there were sex differences in the angiographic and clinical parameters during the acetylcholine provocation test, incidence of CAS, risk factors of CAS, 5-year MACE, and recurrent angina. Old age, dyslipidemia, and MB were independent risk factors of CAS in both sexes. However, major clinical outcomes up to five years in CAS patients were not different according to sex.

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Jansen, Tom, Martin Gathen, Amadeo Touet, Hans Goost, Dieter Christian Wirtz, Christof Burger, Robert Pflugmacher, Kristian Welle, and Koroush Kabir. "Spine Examination during COVID-19 Pandemic via Video Consultation." Zeitschrift für Orthopädie und Unfallchirurgie 159, no. 02 (February 2, 2021): 193–201. http://dx.doi.org/10.1055/a-1283-7160.

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Abstract Introduction During the current COVID-19 pandemic video consultations are increasingly common in order to minimize the risk of infection for staff and patients. The aim of this study was to evaluate the feasibility of a spine examination via video. Methods A total of 43 patients were recruited. Each participant underwent a video-based (VB) and a conventional face-to-face (FTF) spine examination. Pain intensity, active range of motion, inspection, a neurophysiologic basic exam and provocations tests were evaluated using video-based and face-to-face methods. Results The intra-rater reliability (IRR) was measured between both examinations. Good to very good IRR values were obtained in inspection (Kappa between 0,752 und 0,944), active range of motion and basic neurophysiological examination (Kappa between 0,659 und 0,969). Only moderate matches were found in specific provocation tests (Kappa between 0,407 und 0,938). A video-based spine examination is a reliable tool for measuring pain intensity, active range of motion and a basic neurophysiologic exam. Conclusion A basic spine examination during a video consultation is possible. A good agreement of the test results between video-based and face-to-face examination could be found.

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Thalhamer, Christoph, Julia Hahne, Omer Matthijs, and Peter Machacek. "Inter-Rater Reliability of Pain Provocation Tests for Painful Lumbar Facet Joints. A Pilot Study." Zeitschrift für Orthopädie und Unfallchirurgie 157, no. 03 (November 6, 2018): 254–62. http://dx.doi.org/10.1055/a-0748-6081.

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Abstract Background With a life-time prevalence of 39%, low back pain (LBP) is one of the most common musculoskeletal disorders. Correct diagnosis of underlying causes is commonly seen as a prerequisite for successful therapy of LBP. Currently, there is no useful, non-invasive clinical test to diagnose painful lumbar zygapophyseal joints. Clinical tests with high diagnostic accuracy are therefore desirable. Inter-rater reliability is commonly seen as a prerequisite of test validity. The objective of this pilot study was thus to evaluate inter-rater reliability of new clinical pain provocation tests for diagnosing painful lumbar zygapophyseal joints. If a clinically significant level of inter-rater reliability were to be determined, this study could constitute a first step towards establishing the clinical utility of this new set of tests in the structural diagnosis of low back disorders. Material and Methods Patients participating in this study were recruited in a specialist hospital throughout June 2015 until September 2016. Both female and male patients with current LBP, with or without buttock or lower extremity symptoms were screened for inclusion. Patients had preferably to be 50 years or older in order to be included in this study. The upper age limit was set at 90 years. They also had to be fluent in German to be able to follow verbal instructions. Exclusion criteria comprised the presence of red flags, surgical spinal fusion at any level of the lumbar spine, discectomy within the past 12 months, radiculopathy and/or radicular pain, interventional treatments for the IVD, SIJs or ZAJs within the past three months, psychiatric disorders, current litigation issues concerning back pain, and central nervous system diseases. Three certified manual therapy instructors tested patients independently. Fleissʼ kappa values and percent agreements were calculated. Results Subjects included a sample of 48 patients (15 males and 33 females) with a mean age of 66.48 years (range 33 – 90) presenting at a specialist hospital with low back pain. The new pain provocation tests for lumbar zygapophyseal joints showed moderate reliability (Fleissʼ κ = 0.46) and an overall percent agreement of 68.8%. Separate tests for the zygapophyseal joints of L5–S1 showed fair reliability (Fleissʼ κ = 0.37) and an overall percent agreement of 64.6%. Unidimensional tests that were used in the study to exclude the intervertebral disc as a nociceptive generator showed fair reliability as well (average κ of 0.28 and 0.39, respectively). Neither drop outs nor adverse events occurred. Conclusion The new pain provocation tests for lumbar zygapophyseal joints showed clinically significant levels of inter-rater reliability. Validation of these tests against fluoroscopy-guided medial branch blocks is warranted.

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Syed Iqbaluddin, Juwairiya, Fathima Murthuza, and Sumaiya Iqbal. "Diagnosis of Brugada Syndrome, a Rare Inherited Arrhythmogenic Disorder." Dubai Medical Journal 3, no. 2 (April 15, 2020): 70–73. http://dx.doi.org/10.1159/000507572.

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Brugada syndrome (BrS) is a rare, autosomal dominant genetic disorder with mutation in the SCN5A gene. It is associated with an increased risk of arrhythmias and sudden cardiac death. BrS can be diagnosed by characteristic electrocardiogram (ECG) findings and significant events, such as syncope, palpitations, nocturnal respiratory agonia, and family history of sudden cardiac death below the age of 45 years. Special investigations, such as electrophysiology study, ajmaline provocation test, and genetic testing, play an important role in its diagnosis. This case report describes a patient who presented with chest pain and dizziness along with a positive family history of sudden cardiac deaths below the age of 45 years. He was discovered to have type 2 Brugada pattern on ECG, and by ajmaline provocation test, the type 1 pattern was unmasked, which established a definitive diagnosis of BrS. The patient was then advised for an implantable cardioverter-defibrillator. This case highlights the need for physicians to be competent in identifying patients with BrS in order to provide the necessary management and prevent fatal outcomes.

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Kang, Min Gyu, Kye-Hwan Kim, Jin-Sin Koh, Young-Hoon Jeong, Jin-Yong Hwang, and Jeong Rang Park. "Conventional Coronary Angiography Induced Takotsubo Cardiomyopathy Complicated with Cardiac Tamponade." Case Reports in Cardiology 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/5631264.

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Takotsubo cardiomyopathy (TCM) is a transient left ventricular dysfunction that typically occurs after emotional or physical stress. TCM has a benign prognosis and serious complications are uncommon. However, though very rarely reported, cardiac tamponade has occurred on some occasions. We hereby report the case of a 70-year-old woman who underwent coronary angiography with an ergonovine provocation test to evaluate recurrent chest pain and was readmitted 7 days later presenting with TCM, followed by left ventricular outflow tract obstruction and cardiac tamponade.

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Wolfer, Lee. "Systematic Review of Lumbar Provocation Discography in Asymptomatic Subjects with a Meta-analysis of False-positive Rates." Pain Physician 4;11, no. 8;4 (August 14, 2008): 513–38. http://dx.doi.org/10.36076/ppj.2008/11/513.

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Background: Lumbar provocation discography is a controversial diagnostic test. Currently, there is a concern that the test has an unacceptably high false-positive rate. Study Design: Systematic review and meta-analysis. Objective: To perform a systematic review of lumbar discography studies in asymptomatic subjects and discs with a meta-analysis of the specificity and false-positive rate of lumbar discography. Methods: A systematic review of the literature was conducted via a PUBMED search. Studies were included/excluded according to modern discography practices. Study quality was scored using the Agency for Healthcare Research and Quality (AHRQ) instrument for diagnostic accuracy. Specific data was extracted from studies and tabulated per published criteria and standards to determine the false-positive rates. A meta-analysis of specificity was performed. Strength of evidence was rated according to the AHRQ U.S. Preventive Services Task Force (USPSTF) criteria. Results: Eleven studies were identified. Combining all extractable data, a false-positive rate of 9.3% per patient and 6.0% per disc is obtained. Data pooled from asymptomatic subjects without low back pain or confounding factors, shows a false-positive rate of 3.0% per patient and 2.1% per disc. In data pooled from chronic pain patients, asymptomatic of low back pain, the false-positive rate is 5.6% per patient and 3.85% per disc. Chronic pain does not appear to be a confounding factor in a chronic low back pain patient’s ability to distinguish between positive (pathologic) and negative (non-pathologic) discs. Among additional asymptomatic patient subgroups analyzed, the false-positive rate per patient and per disc is as follows: iliac crest pain 12.5% and 7.1%; chronic neck pain 0%; somatization disorder 50% and 22.2%, and, post-discectomy 15% and 9.1%, respectively. In patients with chronic backache, no false-positive rate can be calculated. Low-pressure positive criteria (≤ 15 psi a.o.) can obtain a low false-positive rate. Based on meta-analysis of the data, using the ISIS standard, discography has a specificity of 0.94 (95% CI 0.88 – 0.98) and a false-positive rate of 0.06. Conclusions: Strength of evidence is level II-2 based on the Agency for Healthcare Research Quality (USPSTF) for the diagnostic accuracy of discography. Contrary to recently published studies, discography has a low false-positive rate for the diagnosis of discogenic pain. Key words: Meta-analysis, lumbar discography, false-positive, asymptomatic subjects

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Rizwan, Razia, Mohsana Tariq, Sahreen Anwar, and Raheela Kanwal. "POSTERIOR PELVIC PAIN." Professional Medical Journal 25, no. 12 (December 8, 2018): 1823–27. http://dx.doi.org/10.29309/tpmj/18.4924.

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Background: Pregnancy related posterior pelvic pain (PRPPP) is a common complaint among pregnant females. It is one of main source for disability, absence from work and is responsible for direct and indirect economical impact. Purpose of the Study: To investigate the prevalence of pregnancy associated posterior pelvic pain and to ascertain its occurrence in three trimesters of pregnancy. Study Design: Cross sectional survey. Setting: District Head Quarter Hospital Sargodha & Gynae OPDs of different clinics. Period: Jan 2013 to Dec 2013. Materials and Methods: 200 pregnant females, the range of age group was 16-42 years and participants were selected through convenience sampling technique. All pregnant females were interviewed using structured questionnaire having open and close ended questions. Posterior pelvic pain provocation test and Gaenslen’s test were performed on all females with lumbo-pelvic pain and intensity of pain was measured, using visual analogue scale. Results: 200 pregnant females were studied, 140 (70%) pregnant females were in 2nd or 3rd trimesters of pregnancy and 102 (51%) reported posterior pelvic pain, and amongst 60 pregnant females in 1st trimesters showed only 10 (5%) reported posterior pelvic pain. All pregnant females (n=112,56%) having posterior pelvic pain showed positive posterior pelvic pain tests and Intensity of pain in pregnant females with pelvic girdle pain in 1st, 2nd and 3rd trimesters measured using visual analogue scale, with mean value 6.09 ( SD= 2.16). Conclusion: About 2 in every 3rd femalesstudied; reported to have posterior pelvic pain, more in 2nd and 3rd trimesters of pregnancy as compared to 1st trimester of pregnancy. The high prevalence causes considerable health problem, physical dysfunction, and poor work performance in Pakistani pregnant females andneed more attention by health professionals and researchers.

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Walker, Lynn S., Sara E. Williams, Craig A. Smith, Judy Garber, Deborah A. Van Slyke, Tricia Lipani, John W. Greene, Howard Mertz, and Bruce D. Naliboff. "Validation of a Symptom Provocation Test for Laboratory Studies of Abdominal Pain and Discomfort in Children and Adolescents." Journal of Pediatric Psychology 31, no. 7 (August 17, 2005): 703–13. http://dx.doi.org/10.1093/jpepsy/jsj062.

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Chanal, I., J. Bousquet, B. Arnaud, O. Dupin, and C. Trinquand. "Comparaison d'un nouveau collyre anti-allergique, la lévocabastine versus NAAGA, dans le test de provocation conjonctivale." Revue Française d'Allergologie et d'Immunologie Clinique 34, no. 5 (October 1994): 420–23. http://dx.doi.org/10.1016/s0335-7457(05)80253-9.

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Fauquert, J. L., A. Deschildre, D. Sabouraud, and F. Rancé. "Test de provocation par voie orale aux aliments chez l'enfant. Quand, pour qui et comment ? Interprétation." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 7 (November 2006): 670–74. http://dx.doi.org/10.1016/j.allerg.2006.08.004.

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Santos, C., A. Deschildre, E. Paty, L. Couderc, C. Marguet, and F. Rancé. "Test de provocation par voie orale aux aliments chez l'enfant. Quand, pour qui et comment ? Réalisation,." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 7 (November 2006): 659–69. http://dx.doi.org/10.1016/j.allerg.2006.08.006.

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Deschildre, A., F. Rancé, C. Santos, and C. Castelain. "Test de provocation par voie orale aux aliments chez l'enfant. Quand, pour qui et comment ? Conséquences." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 7 (November 2006): 675–79. http://dx.doi.org/10.1016/j.allerg.2006.08.007.

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Díaz-Sáez, Marta, Cristina Sáenz-Jiménez, Jorge Hugo Villafañe, Alba Paris-Alemany, and Roy La Touche. "Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial." Journal of Clinical Medicine 10, no. 19 (September 27, 2021): 4434. http://dx.doi.org/10.3390/jcm10194434.

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Objective: The present trial aimed to compare the effects of the mobilisation of the nervous system (NS) to those of a soft-tissue intervention in subjects exposed to an experimentally induced hyperalgesia of the masticatory muscles. Methods: The study was a single-blinded randomised controlled trial. A total of 49 participants (mean ± SD age: 41 ± 11 years; 61% female) with latent myofascial trigger points (LMTrPs) in the craniofacial region were randomly assigned to one of three groups: neural mobilisation (NM), soft-tissues techniques and stretching (STT-S), and control group (CG). An initial assessment (baseline) was performed before the provocation chewing masticatory test. The pre-treatment measurements were registered 24 hours later. Next, the randomised intervention was applied, and afterwards, post-treatment data were obtained. Outcome measures included pain-free maximum mouth opening (MMO), pressure pain thresholds (PPTs) in the trigeminal and cervical region, and trigeminal and cervical two-point discrimination (TPD). Results: ANOVA revealed significant differences for the time × group interaction for pain-free MMO and PPTs. The results showed an improvement in the MMO and the PPTs for NM and STT-S groups but not for the CG. There were no differences between the NM and STT-S groups. However, the effect sizes were large for the NM and medium for the STT-S. No differences were found for TDP between groups nor over time. Conclusion: The results show that with NM and STT-S techniques, we could influence motor and sensory variables in asymptomatic subjects with LMTrPs after a masticatory provocation test. Both techniques increased MMO and PPTs in the short term. These beneficial effects lead us to consider the importance of including these methods in clinical practice.

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Al-Mutairi, N., A. Al-Fouzan, and Osama Nour-Eldin. "Fixed Drug Eruption Due to Influenza Vaccine." Journal of Cutaneous Medicine and Surgery 8, no. 1 (January 2004): 16–18. http://dx.doi.org/10.1177/120347540400800104.

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Two females, one 28 years old and the other 32 years old, developed dusky red macules with pain and a burning sensation within 24 hours of receiving influenza vaccine. One patient had blisters within the lesion. A clinical diagnosis of fixed drug eruption (FDE) due to influenza vaccine was made. Histopathology was consistent with the diagnosis of FDE. The lesions subsided within 2 weeks of topical corticosteroid treatment. The diagnosis was confirmed by topical provocation test with influenza vaccine. A Medline search revealed these cases to be the second report of this kind of reaction due to influenza vaccine.

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Kim, Sunwon, Seung-Woon Rha, Amro Elnagar, Byoung Geol Choi, sung il Im, Jin Oh Na, Seongwoo Han, et al. "IMPACT OF INCREASED BASAL TONICITY OF CORONARY ARTERY ON ACETYLCHOLINE PROVOCATION TEST RESULT IN KOREAN PATIENT WITH CHEST PAIN." Journal of the American College of Cardiology 59, no. 13 (March 2012): E176. http://dx.doi.org/10.1016/s0735-1097(12)60177-6.

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Sivakumar, S., M. Kamalakannan, Arun B, A. P. Kalpana, J. Prakash, and K. Vishnu Pradeep. "Prevalence of sacroiliac joint dysfunction in college students." Biomedicine 41, no. 2 (July 2, 2021): 293–96. http://dx.doi.org/10.51248/.v41i2.799.

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Introduction and Aim: Sacroiliac (SI) joint is considered as one of the pain generators in students. Sacroiliac joint dysfunction is one of the common sources of low back pain, and many times the SI joint dysfunction mis-lead as the lumbar problem. Students who sit for longer duration cause stress in the sacroiliac joint. So, this study intended to investigate the prevalence and the contributing risk factors amongst students’ population with work-related musculoskeletal problems and also to identify the percentage of SI joint involvement in them.Materials and Methods: The study was conducted with 590 students from a private paramedical college, involving full time college students, with age group of 17-27 years, no recent falls or those not on current medications related to any musculoskeletal problems, and students without any congenital problems. Evaluation was done using Nordic musculoskeletal questionnaire along with a self-developed demographic questionnaire. The involved students were assessed using questionnaire and sacroiliac joint tests to identify the SI Joint dysfunction. Provocation tests included i) Sacroiliac joint distraction test, ii) SI Compression test iii) Thigh thrust test iv) Faber’s test and v) Gaenslen’s Test. Inference considered was presence of pain in more than 3 test indicates Sacroiliac joint involvement. On completion of assessment, a thank you card was given to all the volunteer students participated in the study. The collected data was filled and analyzed.Results: The study results showed that students with lower back pain also had complaints of neck pain. It was also noted that about 30% of the individuals were positive to the sacroiliac joint tests, among them 93 participants complained of low back pain.Conclusion: This study concluded that 61% of individuals were suffering with musculoskeletal disorders in the selected population. Around 30% of the low back pain participants complained of sacroiliac joint dysfunctions.

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Ujsasi, Darijan, Karmela Filipović, Jelena Zvekić-Svorcan, Marko Nemet, Aleksandar Đuričin, Radojka Jokšić-Mazinjanin, Slobodan Pavlović, et al. "The Applicability of Provocative Functional Tests in the Diagnosis of Rotator Cuff Muscle Injuries of the Best University Athletes." BioMed Research International 2022 (October 13, 2022): 1–9. http://dx.doi.org/10.1155/2022/7728277.

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Rotator cuff disease, external and internal impingement syndromes, low shoulder stability, various types of trauma, and overuse injuries are all related to sports activities. In order to check symptoms in patients with disability and shoulder pain, clinicians use different methods and diagnostic imaging assessment. The research is aimed at evaluating whether there is a difference between provocation function tests (PFT) and ultrasonographic (US) testing of muscles within the rotator cuff in elite collegiate athletes. Patients ( n = 184 ) were recruited from university team sports selections and tested with a standardized US examination of the shoulder and five PFTs (Speed’s test, Neer’s test, Hawkins test, lift-off test, Yergason’s test). Based on the VAS pain assessment scale, 60 subjects had some pain, which was taken for further processing in the work (124 subjects did not have the presence of pain and were excluded from further processing). The US examination was conducted using Voluson 730 apparatus, by a linear probe, with the frequency in the range of 6-12 MHz. The chi-square test showed significant differences between PFT and the occurrence of shoulder muscle tendinitis for the following variables: Speed’s test and subscapularis tendinitis ( p = 0.02 ) and Speed’s test and infraspinatus tendinitis ( p = 0.01 ); Neer test and biceps brachii caput longum tendinitis ( p = 0.01 ), Neer test and supraspinatus tendinitis ( p = 0.02 ) and Neer test and infraspinatus tendinitis ( p = 0.01 ); lift-off test and subscapularis tendinitis ( p = 0.05 ); and Yergason’s test and biceps brachii caput longum tendinitis ( p = 0.03 ) and Yergason’s test and subscapitis tendinitis ( p = 0.01 ). The greatest effect of differences was observed in Neer’s test and biceps brachii caput longum tendinitis ( φ = 0.60 ), while the other effects can be described as medium and small in most cases. It can be concluded that functional tests are good predictors of soft tissue changes in the muscles of the rotator cuff of the shoulder. Further monitoring and analysis are needed on a larger number of athletes.

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Villard-Truc, F., S. A. Gomez, A. Deschildre, and F. Rancé. "Test de provocation par voie orale aux aliments chez l'enfant. Quand, pour qui et comment? Sélection des patients." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 6 (October 2006): 610–24. http://dx.doi.org/10.1016/j.allerg.2006.08.003.

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Rancé, F., and A. Deschildre. "Test de provocation par voie orale aux aliments chez l'enfant. Quand, pour qui et comment? Introduction, définitions, lexique." Revue Française d'Allergologie et d'Immunologie Clinique 46, no. 6 (October 2006): 604–9. http://dx.doi.org/10.1016/j.allerg.2006.08.005.

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Loncar, Jovana, Zorica Panic, Ivana Stojsin, Slobodan Savovic, and Bojan Petrovic. "Applicability of visual-analogue scale in patients with orofacial pain." Srpski arhiv za celokupno lekarstvo 141, no. 7-8 (2013): 454–59. http://dx.doi.org/10.2298/sarh1308454l.

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Introduction. Orofacial pain occurs in various disorders of the orofacial region. Objective. The aim of this study was to examine applicability of the visual-analogue scale (VAS) in patients with orofacial pain (model of acute and chronic pain). Methods. The study involved 60 patients, aged 18-70 years. The first group consisted of patients with dentin hypersensitivity, and the second group of patients with chronic rhinosinusitis. All patients were asked to fill-in a pain questionnaire and to rate pain intensity on the modified visual analogue scale (VAS; 0-10). Air indexing method was performed in the patients with dentin hypersensitivity in order to provoke pain, while the patients with chronic rhinosinusitis underwent CT imaging of paranasal sinuses. Wilcoxon?s test and Pearson?s correlation coefficient were used for statistical analysis. Results. In patients with dentin hypersensitivity provocation increased subjective feeling of pain, but without statistical significance (t=164.5; p>0.05). In patients with chronic rhinosinusitis a significant statistical correlation (r=0.53; p<0.05) was found between subjective pain assessment of VAS and CT findings. Conclusion. Applying VAS in the evaluation of acute and chronic pain can indicate progression or regression of pathological state under clinical conditions. This study showed that VAS, as a method for follow-up of pathological state, is more applicable and efficient when applied in chronic pain evaluation.

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Aggarwal, Amita, and Sarvanan Jayakrishnan. "Sensory and Knee Range of Motion Responses of Slump Test on Unaffected and Radiculopathy Affected Limb in Patients with Lumbar Disk Herniation." Journal of Postgraduate Medicine, Education and Research 50, no. 1 (2016): 1–4. http://dx.doi.org/10.5005/jp-journals-10028-1182.

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ABSTRACT Background Disk herniation is common—it is seen in up to a quarter of magnetic resonance imaging (MRI) and can be detected even in asymptomatic adults. The slump test has become widely advocated as a neural tissue provocation test for clinical assessment of patients with spinal and lower limb pain. The purpose of this study was to determine the sensory and terminal knee extension limitation responses produced during slump test on radiculopathy affected and unaffected limb in patients with lumbar disk herniation. Objectives To compare the sensory and knee range of motion (ROM) responses produced during slump test on affected and unaffected limb. Materials and methods Fifty patients, 25 to 45 years of age chronic disk herniation patients with unilateral radiculopathy with/without lower backache. Patient underwent standardized history and physical examination followed by slump test. Outcomes included terminal knee extension limitations and sensory response produced in terms of intensity numeric rating scale (NRS), nature and location (pain drawings). Results During slump test end position, NRS score and restricted terminal knee ROM comparative results were highly significant (p < 0.001). Based on nature and location of sensory response, maximum number of subjects in affected limb had pain in center of lower back radiating to whole lower limb and for unaffected limb stretch at back of knee. Conclusion In this study, it was suggested that though sensory and knee ROM responses are present in both affected and unaffected limb but the radiculopathy affected limb was more affected in terms of intensity of pain and limitation of motion. How to cite this article Aggarwal A, Jayakrishnan S, Singh A. Sensory and Knee Range of Motion Responses of Slump Test on Unaffected and Radiculopathy Affected Limb in Patients with Lumbar Disk Herniation. J Postgrad Med Edu Res 2016;50(1): 1-4.

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