Hip
Fractures / Osseous
Evidence: confirmed
Patellar-Pubic Percussion Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Detecting Occult Hip Fractures when X-rays are negative.
How to Perform
- Position: Patient supine. Place stethoscope on the pubic symphysis.
- Action: Tap (percuss) the patella of the affected leg.
Interpretation of Results
- Positive Test: Sound is dull or diminished on the affected side (fracture disrupts sound transmission).
- Negative: Sound is distinct and crisp (equal to healthy side).
Diagnostic Accuracy
- Sensitivity: 96%
- Specificity: 76%
Clinical Context & Limitations
The Patellar-Pubic Percussion Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Hip region, combining the Patellar-Pubic Percussion Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
