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  • Title: Development of a preliminary multivariable diagnostic prediction model for identifying active spondylolysis in young athletes with low back pain.
    Author: Therriault T, Rospert A, Selhorst M, Fischer A.
    Journal: Phys Ther Sport; 2020 Sep; 45():1-6. PubMed ID: 32534433.
    Abstract:
    AIMS: The primary aim of this study was to develop a diagnostic cluster of common clinical findings that would assist in ruling out an active spondylolysis in adolescent athletes with low back pain (LBP). DESIGN: Retrospective case-series. SETTING: Hospital-based sports medicine clinic. PATIENTS: One thousand and twenty-five adolescent athletes with LBP (age 15.0 ± 1.8 years, 56% female) were reviewed. Active spondylolytic injuries were identified in 22% (n = 228) of these patients. MAIN OUTCOME MEASURE: presence or absence of active spondylolysis on advanced imaging. RESULTS: Through logistic regression analysis, pain with extension (p < 0.001), difference between active and resting pain ≥3/10 (p < 0.001), and male sex (p = 0.002) were identified as significantly associated with active spondylolysis. The clinical cluster had a sensitivity of 88% (95% CI 83%-93%) to help rule out active spondylolysis. The negative likelihood ratio was 0.34 (95% CI 0.23-0.51) and the negative predictive value was 90% (95% CI 86%-93%). Diagnostic accuracy of the cluster was acceptable (area under the curve = 0.72 (95% CI 0.69, 0.76; p < 0.001). CONCLUSION: This study found a cluster of three patient characteristics that may assist in ruling out active spondylolysis in adolescent athletes with LBP.
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