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[Pysical examination--rebound tenderness].

W A Bemelman1, J Kievit

  • 1Leids Universitair Medisch Centrum, afd. Heelkunde, Leiden.

Nederlands Tijdschrift Voor Geneeskunde
|April 30, 1999
PubMed
Summary
This summary is machine-generated.

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Rebound tenderness is a common diagnostic test for acute abdominal pain, but it has low specificity, leading to many false positives. This physical examination technique offers limited additional value in diagnosing appendicitis, especially when other signs are present.

Area of Science:

  • Clinical Medicine
  • Diagnostic Procedures
  • Surgical Assessment

Context:

  • Acute abdominal pain is a common clinical presentation requiring accurate diagnosis.
  • Rebound tenderness is a frequently employed physical examination maneuver.
  • The diagnostic utility of rebound tenderness in acute conditions, particularly appendicitis, is under scrutiny.

Purpose:

  • To evaluate the diagnostic accuracy of rebound tenderness in acute abdominal pain.
  • To determine the sensitivity and specificity of rebound tenderness for appendicitis diagnosis.
  • To assess the added value of rebound tenderness in conjunction with other clinical findings.

Summary:

  • Rebound tenderness demonstrates high sensitivity (pooled: 0.91) but low specificity (pooled: 0.60) for diagnosing acute appendicitis.

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  • The test causes significant patient discomfort.
  • Its low specificity results in a high rate of false positives, questioning its clinical utility.

    • Impact:

    • Findings suggest rebound tenderness has limited diagnostic value, especially when local tenderness or rigidity are present.
    • Clinicians should consider the low specificity and potential for false positives when interpreting this sign.
    • This evidence may influence clinical guidelines for abdominal pain assessment.