Review Article
Year: 2017 | Month: Aug | Volume: 7 | Issue: 8 | Pages: 473-478
A Comparison of Diagnostic Imaging and Vibrating Tuning Forks in the Detection of Fractures
Derek Charles1*, Ashleigh Elkins*, Andrew Kneeburg*, Kelsey Nikkila*
1Assistant Professor
*Department of Physical Therapy Tennessee State University 3500 John A Merritt Boulevard Nashville TN.
Corresponding Author: Derek Charles
ABSTRACT
INTRODUCTION: The purpose of this review was to determine the effectiveness of tuning forks compared to diagnostic imaging in ruling out and ruling in fractures.
METHODS: Multiple databases including Ebscohost, Pub Med, and Sport Discus were utilized in the literature review. Keywords included tuning fork test, fracture detection, x-ray, ultrasound, MRI, bone scan, CT scan, and diagnostic imaging. Inclusion criteria included Oxford Level of Evidence 3 or higher, statistics on sensitivity, specificity, and reliability, peer-reviewed, and English only journals. 9 articles published between 1997 and 2016 were included in the synthesis of the results.
RESULTS: For the tuning fork test, sensitivity ranged from 75% to 92%, specificity ranged from 18% to 94%, positive likelihood ratios were between 1.1 and 16.5 and negative likelihood ratios were between .09 and 1.62. Either pain induction or reduction of sound transmission while listening with a stethoscope was used for fracture detection but there was not standardization in training or methodology.
CONCLUSIONS: MRI continues to be the preferred method of fracture detection due to its high sensitivity and specificity. Computed Tomography and bone scans also demonstrated high specificity and sensitivity. While a tuning fork is simple to administer and cheap, it has low diagnostic capabilities when used alone, and therefore other imaging is still necessary for confirmation even with a positive or negative test.
Key words: tuning forks, fractures, x-rays, MRI, diagnostic imaging, diagnostic accuracy