title: Poor sensitivity of musculoskeletal history in children.
abstract: OBJECTIVE
  To demonstrate the sensitivity of musculoskeletal (MSK) history taking.
  
  
  METHODS
  Prospective study: consecutive children attending outpatient clinics.
  
  
  METHODS
  Paediatric rheumatology clinic (n=45; girls n=28; median age 12 years, range 3-18), acute general paediatric assessment unit (n=50; girls n=21; median age 8 years, range 3-16).
  
  
  METHODS
  Pro forma recording abnormal joint involvement from history taking and then following MSK examination completed by clinicians.
  
  
  METHODS
  Sensitivity of MSK history taking compared with clinical examination.
  
  
  RESULTS
  Paediatric rheumatology clinic: 135 abnormal joints identified in 34 children; 53/135 (39%) by history alone, 82/135 (61%) detected on examination resulting in MSK history sensitivity 53%, specificity 98%. Acute paediatric unit: 29 abnormal joints identified in 17 children; 18/29 identified on history (sensitivity 62%).
  
  
  CONCLUSIONS
  MSK history taking failed to identify a large number of abnormal joints which were detected on physical examination, emphasising the need for all joints to be examined as part of a screening examination as a minimum.
authors.affiliation: Newcastle upon Tyne NHS Foundation Trust, Rheumatology, Newcastle upon Tyne NE7 7DN, UK. iain.goff@ncl.ac.uk
authors.forename: Iain
authors.initials: I
authors.lastname: Goff
authors.forename: Amy
authors.initials: A
authors.lastname: Rowan
authors.forename: Belinda Jane
authors.initials: BJ
authors.lastname: Bateman
authors.forename: Helen Elizabeth
authors.initials: HE
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003240:Connective Tissue Diseases / Q000175:diagnosis; D004739:England; D004812:Epidemiologic Methods; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000592:standards*; D009140:Musculoskeletal Diseases / Q000175:diagnosis*; D010044:Outpatient Clinics, Hospital / Q000592:standards; D010808:Physical Examination; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity