title: A new self-diagnostic test for biceps femoris muscle strains.
abstract: OBJECTIVE
  We compared a self-performed diagnostic test that we have been using since 1987, with other commonly used clinical tests for biceps femoris muscle-strain injuries.
  
  
  METHODS
  Private practice focusing on sports injuries.
  
  
  METHODS
  One-hundred forty professional male soccer players (ages 17 to 33 years) with a history and clinical findings of a pulled hamstring muscle (patients with direct trauma were excluded) had an ultrasound-proven grade I or II biceps femoris muscle injury.
  
  
  METHODS
  In these ultrasound-positive patients, the "taking off the shoe" test (TOST) was performed by the patient himself on both the affected and unaffected legs; and the physician then performed the resisted range of motion, passive range of motion, and active range of motion tests.
  
  
  RESULTS
  The TOST had a sensitivity and specificity of 100%, and a positive predictive value and an negative predictive value of 100% for biceps femoris injury as found on ultrasound. The other muscle tests had an average sensitivity of 57%, specificity of 100%, accuracy of 79%, and negative predictive value of 70%.
  
  
  CONCLUSIONS
  This preliminary, nonblinded observational study of the TOST found it to be more reliable than other commonly used clinical tests for hamstring tears. The clinical value of this easy-to-perform test should be evaluated in a prospective fashion.
authors.affiliation: Center for Orthopaedics and Sports Traumatology, and Department of Orthopaedics and Traumatology, University of Baskent, Zubeyde Hanim Hospital, Karsiyaka, Izmir, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Zeren
authors.forename: Haluk H
authors.initials: HH
authors.lastname: Oztekin
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D007869:Leg Injuries / Q000175:diagnosis*; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries*; D016353:Self-Examination / Q000379:methods; D012680:Sensitivity and Specificity; D012775:Shoes; D013848:Thigh / Q000293:injuries*