Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PALPATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed1978

Thyroid scintigram in familial medullary carcinoma of the thyroid gland.

Findings on thyroid scintigram were compared with results of thyroid palpation and size and location of C-cell disease in 68 thyroid lobes of 35 patients with familial medullary thyroid carcinoma (MTC) and high basal or stimulated plasma calcitonin values. Rectilinear scans showed cold nodules in 24 (35%) of 68 lobes. In three lobes, the cold nodules did not coincide with MTC (2 macrofollicular adenomas, 1 colloid goiter). Thus, the true positive rate for rectilinear scans was 31%. Palpation identified nodules in 20 lobes (29%), but the true positive rate was only 26%. Patients with MTC have high basal or stimulated calcitonin values long before the tumor is detectable by scan or even later by palpation. When the tumors were large enough to be seen on thyroid scans, the most frequently encountered single pattern was that of symmetrically located cold nodules in the middle of otherwise normal thyroid lobes. This pattern, if encountered in a thyroid scan, should raise the suspicion of MTC.

Adolescent↗
PubMed2003

Clinical effectiveness of the physical examination in diagnosis of posterior pelvic ring injuries.

OBJECTIVE: To determine if physical examination (PE) of the posterior pelvis in awake and alert trauma patients with known pelvic ring injuries can accurately predict a potentially unstable posterior ring injury and guide the use of computed tomography (CT) more effectively. DESIGN: Patients with pelvic fracture noted on anteroposterior (AP) pelvic radiographs were prospectively evaluated over a 21-month period. AP, inlet, and outlet radiographs as well as CT scans were obtained on all patients. SETTING: Level I trauma center. PATIENTS: Patients were excluded who had a Glasgow Coma Scale score less than or equal to 12, were unable to cooperate with a PE, were 12 years old or younger, or had concomitant acetabular fracture. INTERVENTION: A focused PE protocol with emphasis on the posterior pelvis, including posterior palpation of the sacrum and sacroiliac joint, AP and lateral iliac wing compression, active hip range of motion, and a digital rectal examination. If an individual PE parameter resulted in tenderness, it was considered positive. MAIN OUTCOME MEASUREMENTS: The 4 PE modalities were compared with CT scan results using sensitivity, specificity, negative predictive value, positive predictive value, likelihood ratio, and McNemar's test for discordant pairs. RESULTS: The study group included 66 patients. Of patients, 49 (74%) had posterior pelvic injury diagnosed by CT scan. Of the patients with positive posterior CT scan findings, 48 (98%) had pain with posterior palpation. Sensitivity and specificity were 0.98 and 0.94, and the likelihood ratio was 16.3. CONCLUSIONS: PE, specifically palpation of the posterior pelvis, in patients with pelvic fractures can accurately detect injuries of the posterior ring.

Adolescent↗
PubMed1988

Selective application of cervical spine radiography in alert victims of blunt trauma: a prospective study.

Four hundred sixty-seven adult victims of blunt trauma undergoing cervical spine radiography (CSR) were prospectively studied to identify any clinical parameters which would aid in the selective application of CSR. Eight persons (1.7%), six of whom were alert and two who presented comatose, sustained cervical spine injuries. In this study, persons injured in falls demonstrated a statistically significant greater risk of cervical spine injury compared to those injured in motor vehicle accidents (p = 0.001). In alert trauma victims, a statistical correlation with cervical spine injury was noted for individuals who had complaints of neck discomfort (p = 0.028) and for patients who manifested tenderness to neck palpation (p = 0.000039). No cervical spine injury was noted in any alert, not intoxicated, neurologically intact patient who had no complaints of neck discomfort upon questioning or palpation. We conclude that alert trauma victims with no complaints of neck discomfort upon questioning and with no tenderness on neck palpation need not undergo CSR.

Adolescent↗
PubMed2000

The value of early and double phase 99Tcm-sestamibi scintimammography in the diagnosis of breast cancer.

The aim of this study was to assess the additional value of early and double phase scintimammography (SMM) with 99Tcm-sestamibi in the detection of breast cancer following initial evaluation by palpation and mammography. Altogether, 322 women with breast lesions evaluated prospectively by palpation, fine-needle aspiration and mammography were assigned a malignancy risk according to the results. Scintimammography was performed in all patients in the prone breast dependent position. Immediate and delayed views were obtained. Acquisition of immediate tracer uptake was termed 'early phase' SMM, whereas a combination of both immediate and delayed phase images was termed 'double phase' SMM. All patients underwent breast biopsy. Both early phase and double phase SMM detected eight of nine tumours in the low-risk group (88.8% sensitivity). In the uncertain cases (moderate-risk group), early phase SMM detected all malignant tumours, but double phase SMM missed one (92.3% sensitivity). In the high-risk group, early phase SMM missed two breast cancers (94.6% sensitivity) and double phase SMM missed four (89.2% sensitivity). Overall, early phase SMM had a sensitivity of 94.9% and a specificity of 80.2% in detecting breast cancer, whereas double phase SMM had a sensitivity of 89.8% and a specificity of 94.3%. Both methods had 100% sensitivity for tumours larger than 1 cm. In conclusion, SMM detected additional breast cancers following an initial evaluation by palpation, fine-needle aspiration and mammography. Our results suggest that double phase SMM is more specific than early phase SMM, although early phase SMM is more sensitive. Whether the interpretation of SMM results should rely on both early and delayed images, or early images alone, should be based on the relative risk of malignancy of the breast lesion as estimated by the initial evaluation.

Adult↗
PubMedDate not supplied

Interobserver and method variability in tuberculin skin testing.

Accurate measurement and interpretation of tuberculin skin tests is essential both to avoid unnecessary prophylactic treatment with potentially hepatotoxic drugs and to ensure the proper institution of therapy in tuberculin-positive individuals. Although two methods are currently used for reading tuberculin skin tests, palpation and ballpoint, the optimal technique has not been established. We compared measurements obtained by each method on 101 patients tested with intermediate tuberculin purified protein derivative. Fifty-eight of these patients were also tested using Mono-Vacc. Excellent interobserver agreement among the five raters was demonstrated for both the palpation and ballpoint techniques. There was no significant difference between the two methods for any reader using the normal 10-mm cutoff point for a positive intermediate tuberculin purified protein derivative test. For any individual observer the decision as to whether the test was positive or negative was unaffected by the method in at least 93% of readings. We conclude that readings by physicians using palpation and ballpoint methods are comparable for clinical decision making.

Adolescent↗
PubMed1990

Technetium-99m (v) dimercaptosuccinic acid: a clinical and scintigraphic study in an animal tumour model.

Technetium-99m (99mTc) (v) dimercaptosuccinic acid (DMSA) is a new tumour-imaging agent which has been used to image head and neck squamous carcinoma. This study used an established rabbit tumour model to compare palpation versus planar scintigraphy in the detection of superficially transplanted cancers. Palpation detected 83% of tumours measuring less than 2 cm compared with 58% for scintigraphy. Overall, the sensitivity for palpation was 88% (77% specificity) compared with 50% (63% specificity) for scintigraphy.

Animals↗
PubMed1993

Metastatic carcinoma in the neck: a clinical computerized tomography scan and ultrasound study.

Metastatic cervical lymph node involvement is a major determinant of treatment planning and prognosis of upper aerodigestive tract tumours. If the metastatic tumor invades the carotid artery wall then complete tumour excision is not possible unless carotid artery ligation or replacement is planned. A prospective study was performed to assess the role of palpation, computerized tomography (CT) and B-mode ultrasound scanning in the detection of metastatic cervical lymph node involvement in patients with upper aerodigestive tract tumours. In particular, detection of carotid artery wall invasion by tumour was examined. Thirty-two neck dissection specimens were available for histopathological confirmation of findings. Palpation under general anaesthesia was 87.5% sensitive and 87.5% specific in the detection of involved nodes. If a positive finding was defined as detection of a node greater than 15 mm in largest diameter, CT scanning was 78.6% sensitive and 93.8% specific, and the sensitivity of ultrasound was 81.3% and specificity was 84.6%. Ultrasound scanning was sensitive in excluding carotid artery wall invasion, identifying five out of five cases with one false positive and no false negative reports. The combination of palpation under general anaesthesia and B-mode ultrasound imaging provides a sensitive means of detecting the presence of metastatic cervical lymphadenopathy and invasion of the carotid artery wall.

Carotid Arteries↗
PubMed2006

Comparison of three sites to check the pulse and count heart rate in hypotensive infants.

BACKGROUND: Current international guidelines state that heart rate counted at the brachial pulse must be absent or <60 b x min(-1) to diagnose cardiac arrest. Some data suggest that this site may not be the best to check cardiac activity. Hypotension is a likely real scenario of the need for chest compressions in infants. We compared the performance of three sites of pulse palpation (brachial, carotid, and femoral) for detecting and counting heartbeat in hypotensive infants. METHODS: In an operating theater of a pediatric teaching hospital in Italy, we studied 40 anesthetized hypotensive infants just prior to surgery, checked by two doctors and two nurses by a cross-sectional, repeated-measures study design. Each examiner, blind to the monitoring data of the patient, was asked to find the infant's arterial pulse within 10 s and count heart rate for 15 s. During each examination, the order of the three sites was randomized. RESULTS: Among successful detections, femoral pulse palpation resulted as the most successful, rapid, and accurate site to detect and count heart rate in hypotensive infants. CONCLUSIONS: Femoral palpation proved to be the best site for detecting heartbeat and counting heart rate in hypotensive infants. These findings challenge the current guidelines. More data are needed, but the current standard of brachial pulse assessment is debatable.

Aging↗
PubMed2000

Improving the predictability of performance by prerace detection of dorsal metacarpal disease in thoroughbred racehorses.

OBJECTIVE: To determine the prevalence of dorsal metacarpal disease in 2-year-old Thoroughbred horses by prerace inspection and to evaluate the effectiveness of a dorsal metacarpal disease detection program on the predictability of race performance (finishing in the order predicted by punters) and the distance between the first- and last-placed horse in a field. DESIGN: A retrospective study using client-owned horses. METHODS: A program of prerace detection of dorsal metacarpal disease using digital palpation of the dorsal aspect of the third metacarpal bone of both forelimbs of 2-year-old Thoroughbreds racing at Ascot racecourse was instituted by the Western Australian Turf Club in December 1995. Horses that had significant pain reaction to digital palpation were considered to have pain due to dorsal metacarpal disease, withdrawn from that day's race and not permitted to race for 6 weeks. The race records of all 2-year-old Thoroughbreds racing at Ascot racecourse from December 1993 until December 1995 were compared with the race results from December 1995 until March 1997, after initiation of the dorsal metacarpal disease detection program. RESULTS: After initiation of the program, horses were racing more predictably over 1100 m (P = 2.09) and 1200 m (P = 3.48). These horses finished closer to the winner over 1100 m (P = 3.39) and over 1200 m (P = 3.13). In 1000 m races, the trend for horses to race more predictably (P = 1.07) and for there to be less distance between first and last (P = 1.72) was not statistically significant. CONCLUSIONS: The program of prerace digital palpation for dorsal metacarpal disease was considered to be beneficial in 2-year-old Thoroughbreds racing over 1100 m and 1200 m, in that they raced more predictably.

Animals↗
PubMed1985

A somatic component to myocardial infarction.

Sixty two patients were randomised to be seen by osteopathic physicians for palpation of the thoracic paravertebral soft tissue, T1-T8. Twenty five patients had clinically confirmed acute myocardial infarction. Of the remainder, 22 without known cardiovascular disease served as controls and 15 were placed in an excluded group because of diagnosed cardiovascular disease other than myocardial infarction. Observations were described in predetermined standard terminology. The control group was found to have a low incidence of palpable changes throughout the thoracic dorsum, and these changes were uniformly distributed from T1 to T8. Examination of the group with myocardial infarction disclosed a significantly higher incidence of soft tissue changes (increased firmness, warmth, ropiness, oedematous changes, heavy musculature), confined almost entirely to the upper four thoracic levels. The 15 patients who were excluded from the experimental group because they had various cardiovascular diseases other than myocardial infarction also showed significantly different changes on palpation compared with the group with myocardial infarction. These findings suggest that myocardial infarction is accompanied by characteristic paravertebral soft tissue changes which are readily detected by palpation.

Adult↗
PubMed1983

Relationship of ovarian contents to plasma progesterone concentration in the swamp buffalo (Bubalus bubalis).

Using rectal palpation and laparoscopy, the relationship of ovarian contents to plasma progesterone concentration during the oestrous cycle, early pregnancy and post partum periods in the swamp buffalo (Bubalus bubalis) was studied. During the oestrous cycle, four stages in the lifespan of the corpus luteum were seen laparoscopically. The mean (+/- sd) concentrations of progesterone in plasma in cows with and without a corpus luteum on their ovaries were 1.49 +/- 0.78 ng/ml (n = 31) and 0.14 +/- 0.09 ng/ml (n = 14), respectively. Plasma progesterone levels reflected age-dependent changes occurring in the cyclic corpus luteum. The accuracy of diagnosing ovarian contents was 82 and 91 per cent for rectal palpation and plasma progesterone levels respectively. Approximately 29 per cent follicles (larger than 10 mm) were incorrectly diagnosed as corpora lutea by rectal palpation.

Animals↗
PubMed1991

Multiparametric evaluation of testicular atrophy due to varicocele.

63 men with palpable left varicoceles were evaluated by semen analysis, scrotal ultrasonography, Doppler sonography, scrotal contact thermography, and radionuclide scanning. 11 (17.4%) patients had bilateral varicoceles detected by scrotal ultrasonography as compared with an incidence of 3.1% by scrotal palpation. Testicular atrophy was found in 29 (46%) patients by scrotal ultrasonography. This was found to be 39.6% by scrotal palpation alone. In this study using advanced diagnostic procedures, the incidences of bilateral varicocele and testicular atrophy due to varicocele were found to be much higher than when scrotal palpation alone was performed.

Adolescent↗
PubMed1989

New ultrasonic femoropopliteal and tibiofemoral tests in the study of patency of the deep venous system.

In phlebology, every new noninvasive examining method is of great importance. Now there are new femoropopliteal and tibiofemoral tests, described originally by Odisio in Argentina and, in a modified form applying ultrasound, introduced in Europe by Krcilek and Barták. An experiment with 25 patients was performed to verify the conclusive evidence of the tests. The diagnosis of deep venous thrombosis was examined here by clinical and femoropopliteal and tibiofemoral tests according to Odisio. Finally the diagnosis was verified by the Doppler ultrasonic method. The principle of the femoropopliteal test is the palpative perception, when the fingertips of the left hand applied to the inguen somewhat medially from the femoral artery detect the deep venous wave caused by a repeated percussion of the right hand in the fossa poplitea. Getting some experience enables one to practice simple examinations leading to verification of a suspected diagnosis of femoral thrombosis. Replacing the palpating hand by a sonde of an ultrasonic detector gave substantial precision to examinations in the test modification. Similarly the diagnosis of deep venous thrombosis of the calf was verified by the percussional tibiofemoral test, when the right hand repeatedly percussed on the calf in the course of crural veins, while the left hand palpated the transmission of the wave to the inguen. Both modifications of the femoropopliteal and tibiofemoral tests were verified by the classical ultrasonic examination method. The results were compared with those from a control group of 25 patients without clinical and phlebogic symptoms of disease of the lower limbs.

Adult↗
PubMed1986

Reliability of a craniomandibular index.

The Craniomandibular Index (CMI) was developed to provide a standardized measure of severity of problems in mandibular movement, TMJ noise, and muscle and joint tenderness for use in epidemiological and clinical outcome studies. The instrument was designed to have clearly defined objective criteria, simple clinical methods, and ease in scoring; it is divided into the Dysfunction Index and the Palpation Index. Inter-rater reliability (three raters) and intra-rater reliability (19 patients examined twice by one rater) were tested to determine whether the instrument has operational definitions sufficiently precise to allow for consistency in use between different raters and with one rater over time. Intraclass Correlation Coefficient for inter-rater reliability was 0.84 for the Dysfunction Index, 0.87 for the Palpation Index, and 0.95 for the CMI. Correlation for intra-rater reliability was 0.92 for the Dysfunction Index, 0.86 for the Palpation Index, and 0.96 for the CMI. These results support the reliability of the CMI for use in epidemiological and clinical studies. Users are cautioned about the subjectivity of numerous items within the CMI and the strict methodological guidelines that must be followed in order to assure accuracy and reproducibility of results.

Humans↗
PubMed1993

Diagnostic value of orthopedic tests in patients with temporomandibular disorders.

For a better definition of diagnostic subgroups of patients with temporomandibular disorders (TMD), clinical orthopedic tests have been developed for the masticatory system, for use together with the commonly used active movement tests and palpation. In the present study, the characteristics and additional diagnostic value of four orthopedic tests--namely, passive opening, the joint play test, compression, and the static pain test--were determined for a patient group, diagnostic subgroups, and a control group. Significant differences among the scores of the tests in the different groups indicated that all six orthopedic tests contributed to the diagnostic process. Because of the close functional relationship of the masticatory system, most information was obtained when patients indicated where pain occurred during the different tests. Logistic regression techniques were used for determination of the relative diagnostic value of each orthopedic test in the diagnostic process. Active movement was the most powerful test for distinguishing the different subgroups. Palpation and passive opening were additionally useful for distinguishing between patients and control subjects and between the subgroups of arthrogenous and myogenous patients. Besides active movement, both compression and the joint play test played a minor role in the distinction of subgroups of arthrogenous patients. It may be concluded that in routine clinical practice, besides history taking and conventional radiography, a functional examination consisting of active movements, passive opening, and palpation provides valuable diagnostic information. In patients with a specific diagnostic problem, one of the other additional tests might be indicated.

Adult↗
PubMed1994

The reliability of clinical methods for recording temporomandibular joint sounds.

Measurement errors in recording temporomandibular joint sounds may originate from variation between observers and from variation in the phenomenon. Laboratory settings enable various procedures to be used to minimize both sources of variation. These procedures yield some excellent intra- and inter-examiner reliabilities, but this does not imply that dentists in a clinical setting are likely to evaluate temporomandibular joint sounds in a comparable way. This study was designed to evaluate clinical joint sound assessment methods (palpation and stethoscopy) without using special precautions to minimize variance. An attempt was made to quantify the signal variance. Within- and between-examiners agreement is estimated for both methods in a sample of 44 non-patients. The results show that two clinically experienced craniomandibular disorders specialists were able to reach fair to good agreement on the identification of (the number of) temporomandibular joint sounds. There was some disagreement with respect to the number of reciprocal clicks. Compared with the palpation technique, stethoscopy is more sensitive, especially with regard to crepitation. Based on the electronically recorded sounds, both examiners appeared to be overconsistent. It is concluded that the use of both palpation and stethoscopy in clinical settings can be justified but that both methods have limitations. When, in a given clinical setting, these limitations are acceptable, there appears to be no need for extra-sensitive but expensive electronic recording devices.

Auscultation↗
PubMed2002

Ability of mothers to assess the presence of fever in their children without using a thermometer.

Fever is a common complaint in paediatrics and the ability of mothers to identify high temperatures in their children when there is no thermometer available needs to be assessed. Atotal of 169 mothers from a low social and economic background were studied to assess the accuracy of fever diagnosis in their children by palpation. In 137 children with axillary temperatures > or = 38 C as measured by a mercury glass thermometer, mothers were able to detect fever by palpation in 104 cases (sensitivity of 75.9%). In another 32 children without fever, 29 were correctly identified (specificity of 90.6%). Only 21% of mothers in the study had a thermometer in their home and only 44% of these knew how to use it properly. Results show that mothers use palpation to assess the presence of fever in their children and are able to do it correctly in most cases.

Brazil↗
PubMed2003

Detection of lesions using differential rates of speckle decorrelation.

Breast lesions that may be cancerous generally possess a higher elastic modulus than the surrounding tissue. Thus, they are sensed to move differently from the surrounding tissue during finger-based palpation. Since the palpation is subjective in nature, a method using ultrasound for detection of the differential motion associated with hard lesions is proposed. It is intended that regions of detected 'lump' be highlighted on top of a conventional B-mode image so that the user can positively associate palpated lumps with specific regions on the anatomical B-mode image. We detect the differential motion associated with a lesion by detecting a local abnormality in a map of image-to-image correlations as the transducer is swept in an elevational direction. Experiments were performed with three different tissue mimicking phantoms. The results indicate that the location of the mobile lesion can be successfully estimated whereas immobile lesions are not very detectable. This approach is simple and requires only a short period of time for each scan. It has practically no theoretical incremental cost.

Breast Neoplasms↗