title: Derivation and identification of questions that act as predictors of abdominal pain of musculoskeletal origin.
abstract: OBJECTIVE
  Although most causes of abdominal pain have a visceral origin, the musculoskeletal system must be considered when the cause is not obvious. This prospective study aimed to identify questions that would aid the diagnosis of patients with abdominal pain of musculoskeletal origin.
  
  
  METHODS
  Assessment of consecutive patients with abdominal pain recruited from gastroenterological outpatient clinics to develop diagnostic pointers to identify abdominal pain arising from musculoskeletal disorders.
  
  
  METHODS
  Subjects with benign abdominal pain, with or without a change in bowel habit, were recruited from gastroenterological clinics. Patients with inflammatory or neoplastic disease were excluded.
  
  
  METHODS
  The study was conducted in the Physiotherapy Department, Addenbrooke's NHS Trust Hospital, Cambridge.
  
  
  METHODS
  A set of questions developed to indicate a musculoskeletal cause of a patient's abdominal symptoms. RESULTS The questions 'Does taking a deep breath aggravate your symptoms?' and 'Does twisting your back aggravate your symptoms?' had a significant positive indication of abdominal symptoms of musculoskeletal origin. The questions 'Has there been any change in bowel habit since onset of your symptoms?', 'Does eating foods aggravate your symptoms?' and 'Has there been any weight change since onset of symptoms?' had a significant negative indication for abdominal symptoms not of musculoskeletal origin. A combination of these questions gave 96% specificity and 67% sensitivity.
  
  
  CONCLUSIONS
  These questions may help with the early identification of patients with abdominal pain of musculoskeletal origin and will be tested in further studies.
authors.affiliation: Department of Physiotherapy, Addenbrooke's NHS Trust Hospital, Institute of Public Health, Cambridge, UK. sparkesv@cardiff.ac.uk
authors.forename: Valerie
authors.initials: V
authors.lastname: Sparkes
authors.forename: A Toby
authors.initials: AT
authors.lastname: Prevost
authors.forename: John O
authors.initials: JO
authors.lastname: Hunter
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity