Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Dr Solomon and colleagues1 point out that the physical examination can aid
the primary care clinician in assessing the likelihood of a torn meniscal
or ligamentous structure and in deciding whether a referral would be beneficial.
However, the authors fail to provide information about the setting from which
patients were recruited in the studies. All of the included studies seem to
have been carried out in orthopedic settings, and the patients were likely
referred for diagnostic arthroscopy. It is likely that in the process of patient
selection many potential false negative test results were excluded, possibly
overestimating the accuracy of these tests when extrapolating to the population
encountered in primary care.
Heintjes EM, Bierma SMA, Bernsen RMD. Physical Examination of Knee Injuries. JAMA. 2002;287(1):40-41. doi:10.1001/jama.287.1.40