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Screening for Referral of Serious Pathology by Physical Examination Tests in Patients with Back or Chest Pain: A Systematic Review

Author

Listed:
  • Federico Andreoletti

    (Departement of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova-Campus of Savona, 17100 Savona, Italy
    These authors contributed equally to this work.)

  • Filippo Maselli

    (Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
    These authors contributed equally to this work.)

  • Lorenzo Storari

    (Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy)

  • Andrea Vongher

    (Departement of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova-Campus of Savona, 17100 Savona, Italy)

  • Monica Erbesato

    (Departement of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova-Campus of Savona, 17100 Savona, Italy)

  • Marco Testa

    (Departement of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova-Campus of Savona, 17100 Savona, Italy)

  • Andrea Turolla

    (Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
    Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy)

Abstract

Objective: To investigate the most common physical examination tests (PET) for the screening for referral of patients with back or chest pain caused by serious pathology. Methods: A systematic review was conducted. Searches were performed on seven electronic databases between June 2020 and December 2021. Only studies evaluating patients with back and/or chest pain with clear reporting of PETs and prompt patient referrals were included. Results: 316 full texts were included, and these studies had a total of 474/492 patients affected by a serious disease. Only 26 studies of them described suspicion of serious disease due to at least one positive PET. Cardiac/pulmonary auscultation and heartbeats/blood pressure measurements were the most frequently reported tests. None of the reported studies included physiotherapists and chiropractors who reported the use of various tests, such as: cardiac and pulmonary auscultation, lung percussion, costovertebral angle tenderness, and lymph node palpation, highlighting a lack of attention in measuring vital parameters. On the contrary, doctors and nurses reported the assessment of the range of motion of the thoracolumbar spine and hip less frequently. Conclusions: Appropriate reporting of PETs is sparse, and their utilization is heterogeneous among different healthcare professionals. Further primary studies are needed to describe PETs results in patients suffering from back and/or chest pain.

Suggested Citation

  • Federico Andreoletti & Filippo Maselli & Lorenzo Storari & Andrea Vongher & Monica Erbesato & Marco Testa & Andrea Turolla, 2022. "Screening for Referral of Serious Pathology by Physical Examination Tests in Patients with Back or Chest Pain: A Systematic Review," IJERPH, MDPI, vol. 19(24), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:24:p:16418-:d:996389
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    Cited by:

    1. Beatrice Lepri & Daniele Romani & Lorenzo Storari & Valerio Barbari, 2023. "Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review," IJERPH, MDPI, vol. 20(5), pages 1-48, February.

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