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PubMed2001

Measuring leg-length discrepancy by the "iliac crest palpation and book correction" method: reliability and validity.

OBJECTIVE: To determine the reliability and validity of a clinical measurement of leg-length discrepancy (LLD), by using the iliac crest palpation and book correction (ICPBC) method. DESIGN: Intra- and interrater reliability and validity determinations. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-four healthy subjects, none of whom had an apparent LLD, as determined by iliac crest palpation. INTERVENTIONS: We induced a simulated LLD (7-53 mm) for each subject. To measure the LLD, the examiner performed the ICPBC method by palpating the iliac crests and correcting identified differences with a book opened to the required number of pages. The thickness of the book correction was measured. MAIN OUTCOME MEASURES: Reliability LLD measurement (n = 20), by using the ICPBC method to measure the LLD; construct validity (n = 34), comparing ICPBC measurement with the extent of the induced LLD; and concurrent validity (n = 14), the difference in heights of the superior aspect of the femoral heads from standing radiographs. RESULTS: The intraclass correlation coefficients (ICCs) for the intrarater and interrater reliabilities were.98 and.91, respectively. The ICCs for the construct and concurrent validities were.62 and.76, respectively. The ICPBC method underestimated the induced LLD by a mean difference +/- standard deviation of 3.8 +/- 10.3mm (p =.055) and the radiologic measure by 5.1 +/- 8.6 mm (p =.043). CONCLUSIONS: The ICPBC technique for measuring LLD is highly reliable and moderately valid. When there is no history of pelvic deformity and the iliac crests can be readily palpated, we recommend using iliac crest palpation to detect LLD, and the book correction to quantify it.

Adult↗

PubMed1991

[Cervical lymph node metastasis: significance of computerized tomography and palpation. A histologically controlled comparison].

Palpation and CT are used before treatment, in addition to sonography, in patients with tumours in the head and neck for lymph node staging. The accuracy of CT in identifying lymph node metastases is 79% and in our clinical material is similar to the accuracy of palpation (81%). Sensitivity of CT (93%) is better than palpation (82%). Specificity of CT (65%) is less than that of palpation (82%). The high percentage of false positives from CT (35%) is due to enlargement of the lymph nodes resulting from sinus histiocytosis or follicular hyperplasia. CT is significantly superior to palpation in demonstrating the relationship of the lymph nodes to the surrounding tissues (vessels, muscles, bones).

Adult↗

PubMed1990

[Cervical lymph node metastases: a histologically controlled comparison of palpation, sonography and computed tomography].

Sonography and CT were used pre-operatively for lymph node staging in patients with head and neck malignancies. The accuracy of the imaging methods surpassed that of palpation (palpation 85%, CT 85%, sonography 90%). Sensitivity was significantly increased from 74% (palpation) to 84% (CT) and 90% (sonography), ie. there was a reduction in false negative findings. Size of lymph nodes was not closely correlated with metastatic involvement. Reactively enlarged lymph nodes were more easily defined by CT and sonography than by palpation. This reduced the specificity of sonography (90%) and of CT (86%) compared to palpation (94%).

Carcinoma, Squamous Cell↗

PubMed1985

Pregnancy diagnosis in the dog: a comparison between abdominal palpation and linear-array real-time echography.

This paper presents quantitative results of canine pregnancy diagnoses performed by abdominal palpation and/or linear-array real-time echography. Each animal was first palpated by an experienced clinician and then another investigator performed ultrasound scanning using a 3 MHz transducer. In other dogs echography was undertaken only when the result of abdominal palpation was negative or doubtful or when the owner requested ultrasound scanning. Using all tests performed between days 20 and 49 of pregnancy (day 0 = day of first mating or insemination), the results of abdominal palpation (n = 116) versus real-time scanning (n = 135) were: sensitivity: 89.0% v 92.9%; specificity: 93% v 96.0%; positive predictive value: 95.6% v 97.5%; negative predictive value: 83.3% v 88.9%. Results of ultrasound tests performed in 97 other dogs were: sensitivity: 92.4%; specificity: 97.7%; positive predictive value: 98.0% and negative predictive value: 91.4%. Almost identical figures were found when only the tests performed between days 25 and 35 of pregnancy were included. It was concluded that real-time ultrasound scanning is an accurate method for discriminating between pregnant and non-pregnant bitches; sensitivity and specificity of the abdominal palpation technique executed by an experienced clinician approach that of ultrasound scanning; small litter size and lack of knowledge of conception date are the main sources of false negative diagnoses.

Abdomen↗

PubMed1993

Repeatability of measurement of tenderness in the neck-shoulder region by a dolorimeter and manual palpation.

OBJECTIVE: The aim of this study was to test the repeatability of dolorimeter measurements in subjects with and without neck-shoulder symptoms and interobserver agreement in manual palpation. The second aim was to analyze how subjects, measures, and the order of attempt influenced the repeatability of pain threshold (PT) measurements. DESIGN: Repeated measurements in 100 female volunteers who were office workers. SETTING: Interobserver repeatability was tested by examining 60 female office employees twice during the same day, and intraobserver repeatability was tested by examining 40 female office employees at an interval of 2 days. PATIENTS: Their mean age was 38 (20-55) years; height was 163 (149-174) cm; and weight was 60 (44-115) kg. MAIN OUTCOME MEASURES: PT measurement by dolorimeter and manual palpation findings of four defined palpation points. RESULTS: The inter- and intraobserver repeatability coefficients of the dolorimeter varied from 0.87 to 0.65; they were lower in subjects with neck-shoulder symptoms (DS) than in subjects with no or occasional symptoms (NOS). The sensitivity and specificity of dolorimeter for neck-shoulder symptoms was poor. The interobserver repeatability of manual palpation at trigger areas of trapezius and levator muscles varied from 0.15 to 0.62. CONCLUSIONS: The repeatability of dolorimeter is good, but sensitivity and specificity for neck-shoulder symptoms are poor. The dolorimeter is a good device for measurement of cervicobrachial tenderness when the subject acts as his or her own control. The repeatability of manual palpation is poor.

Adult↗

PubMed1993

Manual palpation and pain threshold in female office employees with and without neck-shoulder symptoms.

OBJECTIVE: The aim of this study was to quantify myofascial tenderness by using manual palpation and the dolorimeter on female office employees with disturbing neck-shoulder symptoms (DS) and no or occasional neck-shoulder symptoms (NOS). The association among neck-shoulder symptoms, pain threshold, and age was also analyzed. DESIGN: The cross-sectional study of female office employees selected on a voluntary basis from two offices. SETTING: The manual palpation of neck-shoulder muscles was analyzed at 16 palpation points defined before the examination. The pain threshold (PT) was measured at four trigger areas of trapezius and levator muscles. PATIENTS: 160 female office employees with mean age 41 (21-60) years; height was 163 (149-178) cm; and weight was 62 (45-115) kg. MAIN OUTCOME MEASURES: Manual palpation findings of neck-shoulder muscles at 16 defined palpation points and PT measurement of trigger areas in trapezius and levator muscles by a dolorimeter. RESULTS: The mean number of tender points was 7.25 (SD, 4.5) in subjects with DS and 3.44 (SD, 3.8) in subjects with NOS; the difference was significant (p < 0.0001). Suboccipital and trapezius muscles were tender in most cases in both symptom groups. The PTs of trapezius and levator muscles were significantly lower in subjects with DS than in subjects with NOS (p < 0.0001-0.0005). The PT of the trapezius muscles in subjects > or = 39 years old with DS was significantly lower than in those with NOS (p < 0.0007-0.0402). The PT of subjects with DS was lower in subjects 39 years old and older than in younger subjects, while the PT in subjects with NOS was higher in older subjects than in younger ones; the differences were statistically nonsignificant. CONCLUSIONS: Suboccipital and trapezius muscles are often tender in subjects with DS and in those with NOS. The finding that the PT of the trapezius muscle in older subjects with DS decreases while the PT in subjects with NOS increases is interesting and needs further investigation.

Adult↗

PubMed1991

Palpation as a method for evaluating occlusal discrepancies.

In this study, 30 dentists were surveyed about their methods of palpating teeth for the evaluation of premature contacts. Thirty-eight dentists were then tested to determine their ability to discriminate degrees of prematurity using each of two different methods of palpation. The degree of digital pressure used by each dentist during palpation was also measured. The majority of dentists chose the same method for palpation: a single forefinger overlaying the facial surfaces of the central incisors being evaluated. In the discrimination test, the majority of dentists were able to identify reliably occlusal interference of greater than or equal to 50 microns regardless of the palpation method used.

Adult↗

PubMed1994

Plasma cortisol response in dairy cows to vaginoscopy, genital palpation per rectum and artificial insemination.

Response of plasma cortisol concentrations after vaginoscopic examination, palpation of the genital organs per rectum and artificial insemination were investigated in six Holstein-Friesian cows weighing between 510 to 620 kg. Blood samples were collected by indwelling jugular catheter. The experiment was begun at 09:00 hours on the day when cows came into estrus. Blood samples were collected from 30 minutes before to 60 minutes after each treatment at intervals of 5 to 10 minutes. Cows were initially blood-sampled for 90 minutes at the same intervals without giving any treatment and then were subjected to vaginoscopy for 1.5 minutes, palpation of the uterus and ovaries per rectum for 4 minutes and artificial insemination by the recto-vaginal method for 5 minutes. No significant increase in plasma cortisol was shown in cows in estrus following vaginoscopy. Palpation per rectum as well as artificial insemination caused a significant increase in plasma cortisol (P < 0.01) 5 to 10 minutes after the initiation of treatments in cows in estrus. There was a tendency for cows in the luteal phase to show higher plasma cortisol levels after the vaginoscopy than cows in estrus. Adrenal response to palpation per rectum in cows in the luteal phase was similar to that in cows in estrus. Thus, in cows in estrus, palpation per rectum as well as artificial insemination may be potential stressors for cows, causing an increase in plasma cortisol levels. However, the pathophysiological importance of the rise in plasma cortisol levels is not known.

Animals↗

PubMed2004

Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT.

PURPOSE: To compare ultrasonography (US), computed tomography (CT), and palpation for diagnosing supraclavicular lung cancer metastases and to assess the effect of proved metastases on TNM stage and diagnostic work-up. MATERIALS AND METHODS: One hundred seventeen consecutive patients (91 men and 26 women; mean age, 64.0 years) underwent palpation, US, and CT of supraclavicular regions and chest and upper abdominal CT. Fine-needle aspiration cytologic (FNAC) analysis was performed in patients with nodes with a short-axis diameter of 5 mm or greater; cytologic diagnosis was used as the standard of reference. Sensitivities of palpation, US, and CT were compared with McNemar testing. Relationship between size and palpability of nodes with metastasis was evaluated with logistic regression. RESULTS: Supraclavicular metastases were diagnosed cytologically in 30 (26%) of 117 patients: eight (31%) of 26 patients with small cell lung cancer (SCLC) and 22 (24%) of 91 patients with non-small cell lung cancer (NSCLC). Sensitivities of US (1.00; 30 of 30 patients) and CT (0.83; 25 of 30 patients) for detection of metastases were significantly higher (P <.001 and P =.001, respectively) than that of palpation (0.33; 10 of 30 patients). Palpable nodes with metastasis (mean diameter, 25.2 mm) were significantly larger than nonpalpable nodes with metastasis (mean diameter, 13.7 mm) (P =.002). To have a 50% chance of being palpable, nodes with metastasis had to have a diameter of at least 22.3 mm. TNM stage was changed in three of 91 patients with NSCLC, and further invasive diagnostic procedures were prevented in 11 of such patients because it was proved that nonpalpable nodes had metastases. CONCLUSION: Supraclavicular lung cancer metastases were cytologically proved in 26% of patients. Nodes with metastasis were only palpable when markedly enlarged. US tripled the sensitivity of palpation for detection of metastases. Results of US and US-guided FNAC analysis can change the work-up in patients with lung cancer.

Adult↗

PubMed2000

A finite element model of remote palpation of breast lesions using radiation force: factors affecting tissue displacement.

The early detection of breast cancer reduces patient mortality. The most common method of breast cancer detection is palpation. However, lesions that lie deep within the breast are difficult to palpate when they are small. Thus, a method of remote palpation, which may allow the detection of small lesions lying deep within the breast, is currently under investigation. In this method, acoustic radiation force is used to apply localized forces within tissue (to tissue volumes on the order of 2 mm3) and the resulting tissue displacements are mapped using ultrasonic correlation based methods. A volume of tissue that is stiffer than the surrounding medium (i.e., a lesion) distributes the force throughout the tissue beneath it, resulting in larger regions of displacement, and smaller maximum displacements. The resulting displacement maps may be used to image tissue stiffness. A finite-element-model (FEM) of acoustic remote palpation is presented in this paper. Using this model, a parametric analysis of the affect of varying tissue and acoustic beam characteristics on radiation force induced tissue displacements is performed. The results are used to evaluate the potential of acoustic remote palpation to provide useful diagnostic information in a clinical setting. The potential for using a single diagnostic transducer to both generate radiation force and track the resulting displacements is investigated.

Acoustics↗

PubMed1985

Carotid palpation at two exercise intensities.

It remains unclear whether carotid palpation (CP) should be used to count post-exercise heart rate (HR). We hypothesized that the carotid sinus, when stretched or compressed by external pressure, results in an increased nerve activity to the cardiovascular areas in the brain stem, with a resultant increase in parasympathetic activity and a decrease in sympathetic activity. The primary purpose of this study was to investigate the effects of CP and no CP on post-exercise HR determination at two exercise intensities. The secondary purposes were to investigate whether CP during exercise would elicit a decrease in HR and the effects of CP on post-exercise blood pressure. Twenty-one healthy females served as subjects. During the final min of each exercise intensity, two 10-s HRs were recorded by continuous ECG (i.e., 10 s without palpation and 10 s with palpation). Immediately post-exercise at each intensity, the carotid artery was either palpated (Phase I) or not palpated (Phase II). At 60 and 80% intensity, with 10-s CP, post-exercise HR decreased 12.4 and 7 beats . min-1, respectively (both were significant: P less than 0.05). At 60 and 80% intensity, without CP, post-exercise HR decreased 6.1 and 3.3 beats . min-1 in 10-s, respectively (both were significant; P less than 0.05). CP during exercise did not elicit a carotid sinus reflex, and post-exercise CP did not alter blood pressure readings. These findings were generally contrary to previous research on CP and were determined to be important in that the correct technique was used by the investigators.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

Histopathologic study of the so called 'palpation thyroiditis'.

We have reviewed 1066 thyroid lesions and compared the relative incidence of the so called 'palpation thyroiditis' between autoimmune thyroiditis and normal thyroid parenchyme surrounding the nodular thyroid lesion and also discussed the pathogenesis of palpation thyroiditis. The typical histopathologic features of 'palpation thyroiditis' were seen in 275 cases among 467 adenomatous goiters and in none of the autoimmune thyroiditis. We here in this paper suggest that the so called 'palpation thyroiditis' is not merely a secondary phenomenon to mechanical follicular damage by vigorous palpation, but this lesion more likely develops in conditions where certain types of physiologic alteration has occurred in follicular basement membrane, just like a pathogenesis of subacute granulomatous thyroiditis.

Adenocarcinoma↗

PubMed1992

Diagnosis of luteal and follicular ovarian cysts by palpation per rectum and linear-array ultrasonography in dairy cows.

The purpose of this study was to determine and compare the accuracy of palpation per rectum and linear-array ultrasonography for diagnosing follicular vs luteal ovarian cysts in cows. Forty-seven examinations of ovarian cysts from 28 cows were diagnosed by palpation per rectum as either a firm, thick-walled structure (luteal cyst) or a soft, thin-walled structure (follicular cyst) during weekly herd examinations. The ovaries of each cow were then examined by ultrasonography. Ultrasonograms of cysts greater than 25 mm in diameter were diagnosed as luteal or follicular cysts and were recorded on videotape for evaluation by a second clinician. Serum progesterone concentrations at the time of examination were determined by radioimmunoassay and used to classify luteal (greater than 0.5 ng/ml) or follicular (less than or equal to 0.5 ng/ml) cysts. Selection of this discriminatory level was based on response of a proportion of cows with luteal cysts that were given 25 mg of prostaglandin F2 alpha at the time of diagnosis by ultrasonography. Sensitivity and specificity of palpation per rectum for diagnosis of type of ovarian cyst were low (43.3 and 64.7%, respectively). In contrast, sensitivity and specificity of ultrasonography were considerably higher (86.7 and 82.3%, respectively). Agreement between the 2 methods of diagnosis was 57.4%. Overall agreement between the 2 clinicians' diagnoses by ultrasonography was 85.1%. On the basis of our findings, we confirm that luteal and follicular cysts cannot be accurately differentiated by palpation per rectum alone. These data suggest that linear-array ultrasonography is more effective than palpation per rectum for diagnosing type of ovarian cyst in cows.

Animals↗

PubMed1991

Rectal palpation and transmission of bovine leukemia virus in dairy cattle.

To determine whether rectal palpation, using common obstetrical sleeves, serves as a mode of transmission of bovine leukemia virus in dairy cattle, field studies were conducted at 2 dairies. At a commercial dairy, significant difference was not observed in rate of seroconversion in heifers and cows in which the same sleeve or new sleeves were used for palpations. At a university dairy, where cattle were used to teach dairy husbandry and veterinary procedures, significantly (P less than 0.02) greater rate of seroconversion was observed in heifers and cows palpated with unwashed common sleeves than that observed in heifers and cows palpated with sleeves washed between use. Although rectal transmission of bovine leukemia virus under field conditions was documented, it was related to frequency of palpation and age of cattle.

Animals↗

PubMed1989

[Relationship between muscular palpation and three dimensional incisal path at border movement of mandible].

Temporomandibular arthrosis was diversified phases of its development as well as complicated mode of its crisis, due to which no concrete clinical diagnostic procedure has been established yet. However, a close relation of occlusal disturbance with the crisis factor is suggested, and assessments have been made in the prosthetic dentistry, setting a viewpoint at the phases of mandibular movement. Particularly, incisal path at border movement of mandible is made the object for basic assessment since it exhibits intensified condition. On the other hand, importance is attached to Krogh-Poulsen's muscular palpation for diagnosis of the pain and contraction of the masticatory muscle which occur in temporomandibular arthrosis. However, though there is a close relation between the pain or abnormal contraction of the masticatory muscle and the phases of mandibular movement, these diagnostic procedures have been the studies which have dealt with the subjects separately. And no report is seen on the study made of the relation between the phases of incisal path at border movement of the mandible and Krogh-Poulsen's muscular palpation. Accordingly, with the purpose of investigating these relationships, the author has made assessment of the relationship between the result by Krogh-Poulsen's muscular palpation and the form (analogue form) of three-dimensional incisal path at border movement of the mandible summarized and standardized by TMJ gnathological instrument which is evaluated as a recording method with high clinical efficiency as a method with excellent reproducibility of mandibular movement and favorable manipulability. The subjects enrolled were patients with temporomandibular arthrosis and the so-called normal healthy subjects with normally functioning occlusion who are not conscious clinically of the abnormality of the stomatognathic system nor had similar anamnesis. And the following results have been obtained. 1. Results by Krogh-Poulsen's muscular palpation; 1) The 59 so-called normal healthy subjects were classified into 2 groups by Krogh-Poulsen's muscular palpation, and of these, the cases in whom no abnormality was observed were only 5, being 8.5%, and the cases in whom single or multiple test items showed abnormality were 54, being so high rate as 91.5%. The occurring frequency of 5 test symptoms in the 54 cases were; 22 cases with trismus-40.7%; 34 cases with temporomandibular sounds -63.0%; 20 cases with pain -37.0%; 36 cases with tenderness of the lateral pterygoid muscle -66.7%; and 25 cases with disturbance of lateral mandibular movement -46.3%.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗

PubMed1989

Interrater reliability in masticatory muscle palpation.

Muscle palpation is an important procedure in screening for TM disorders and assessing results of treatment outcome studies, but interpretation of response may be subjective and vulnerable to examiner bias. Masticatory muscle palpation scoring was evaluated with respect to interrater agreement on 31 myofascial pain-dysfunction patients participating in a medication study. Two clinicians independently palpated the temporomandibular joints, muscles of mastication, and related head and neck musculature on three different occasions over the 6-week period of the study. Standardization of palpation technique and initial protocol for interpretation of subject response were discussed prior to the first examination. Further clarification and reinforcement of examination methodology and scoring were carried out prior to the second examination, 1 week later. Another 5 weeks passed, with no further standardization, before the third and last examination. A behaviorally anchored scoring system (0 to 3) was used to rate response to palpation. Results indicate that two investigators can achieve a fair degree of reliability when carefully standardized, further interrater standardization can result in higher reliability, and reliability can be maintained over at least a 5-week period of time.

Humans↗

PubMed1981

Carotid palpation, coronary heart disease and exercise rehabilitation.

Heart rate, determined by palpation of the carotid, radial, or temporal artery, is commonly used to monitor exercise intensity. It is known that massage of the carotid artery has a baroreceptor reflex effect on the heart rate. The heart rate, monitored with and without carotid palpation, at rest, during exercise, and immediately post-exercise was determined in 60 male cardiac patients (39-65 years of age) following either myocardial infarction (n=52), bypass surgery (n=6), or those with angina pectoris (n=2). The mean changes in heart rate with carotid palpation in the testing group were -3.5 bpm at rest and -2.2 bpm during exercise; in the training group the changes were +0.8 bpm at rest -3.1 bpm post exercise. While the mean decrease at rest in the testing group was statistically significant, each of the decreases in resting, during, and post-exercise heart rates were too small to be accurately monitored by palpation over a 10- or 15-sec count, a usual procedure in exercise rehabilitation programs. Provided the patients are correctly instructed and technique regularly checked, there appears to be no reason why carotid palpation should not be used in cardiac exercise rehabilitation programs to determine resting, exercise, or post-exercise heart rates.

Adult↗

PubMed1996

[Prostate cancer: palpation versus ultrasonography].

The authors compared in a group of 273 symptomatic patients the effectiveness of palpation and transabdominal USG of the prostate and in a group of 162 patients palpation and transrectal USG of the prostate in diagnosing of prostate carcinoma. Histopathological correlation was available in 203 (74.4%) patients, all of them examined by transrectal USG. From the whole group of 273 patients prostate carcinoma was confirmed in 69 (25.3%). Based on USG examination alone prostate cancer was proved by histopathological methods in three (4.3%) patients with a negative finding on palpation. A disappointment of the USG method was that it did not prove possible to diagnose before operation incidental cancer in 14 (20.3%) patients with BPH. USG made it possible to define more accurately the stage of cancer in groups T2 and T3. The effectiveness was assessed as follows: sensitivity, specificity and total accuracy during palpation was 75.4%, 88.8%, 84.2%, in transabdominal USG: 78.3%, 91.8%, 87.2% and in transrectal USG of the prostated 97.7%, 90.7% and the overall accuracy 92.6%. Despite these results for screening of patients with prostate cancer USG of the prostate can be recommended only after palpation and PSA examination.

Adolescent↗