Derivation of a Clinical Decision Guide in the Diagnosis of Cervical Facet Joint Pain

atmire.migration.oldid1046
dc.contributor.advisorSalo, Paul
dc.contributor.advisorThomas, Kenneth
dc.contributor.authorSchneider, Geoff Martin
dc.date.accessioned2013-06-14T18:01:54Z
dc.date.available2013-11-12T08:00:12Z
dc.date.issued2013-06-14
dc.date.submitted2013en
dc.description.abstractNeck pain is a common problem presenting to health care professionals in a primary care setting. In particular, the facet joint has been implicated as a primary source of pain in 36% - 67% of people with persistent neck pain. The most internationally accepted criterion standard for the diagnosis of facet joint pain is comparative controlled injections of local anaesthetic onto the sensory nerve of the target facet joint. This procedure is invasive, costly, and is often associated with lengthy wait-times. Clinicians often apply findings from the patient history and physical examination prior to referral of their patients for diagnostic facet joint blocks. The diagnostic utility of the clinical examination has raised controversy in the literature. The purpose of this thesis was to derive a clinical decision guide in the diagnosis of cervical facet joint pain. Our research revealed that the manual spinal examination, palpation for segmental tenderness, and extension-rotation tests possess moderate to excellent intra-rater and inter-rater reliability. Our research indicated that positive findings on all three clinical tests might be helpful for clinicians when attempting to identify patients who may respond positively to diagnostic facet joint blocks. Of interest, the manual spinal examination and palpation for segmental tenderness test may be useful screening procedures, as they possessed high sensitivity and low negative likelihood ratios. Future research, in independent samples, is needed to validate our findings or generate other decision guides that are optimal for clinicians to deliver high quality care for their patients with persistent neck pain.en_US
dc.identifier.citationSchneider, G. M. (2013). Derivation of a Clinical Decision Guide in the Diagnosis of Cervical Facet Joint Pain (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25559en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/25559
dc.identifier.urihttp://hdl.handle.net/11023/753
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectMedicine and Surgery
dc.subjectRehabilitation and Therapy
dc.subject.classificationEpidemiologyen_US
dc.subject.classificationCervical spineen_US
dc.subject.classificationClinical Decision Guideen_US
dc.titleDerivation of a Clinical Decision Guide in the Diagnosis of Cervical Facet Joint Pain
dc.typedoctoral thesis
thesis.degree.disciplineMedical Science
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
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