CRITICAL-EVALUATION OF THE 2-MINUTE ORTHOPEDIC SCREENING EXAMINATION

Objective.-To determine the sensitivity and specificity of the 2-minut e, 12-step, orthopedic screening examination. Design.-Prospective, sin gle-blind study. Setting.-National Collegiate Athletic Association Div ision 1 athletics program. Participants.-Two hundred fifty-nine male a nd female varsity athletes. Interventions.-The athletes were screened by five primary care physicians who were ''blind' to each patient's hi story. The athletes were then evaluated by a team of orthopedic surgeo ns who had knowledge of each patient's history. Significant injuries w ere injuries that would limit participation, predispose to injury, or need further evaluation or rehabilitation. Main Results.-A total of 12 0 significant injuries were identified by compiling the results of the history and both physical examinations. Of the significant injuries, 91.6% were detected by history alone. Fourteen of the significant inju ries were missed by the detailed orthopedic examination, but they were detected by the screening examination. The overall sensitivity of the screening examination compared with the results of all three methods was 50.8%, with a specificity of 97.5%, positive predictive value of 4 0.9%, and negative predictive value of 98.3%. Almost half of the false -positive screening findings were shoulder asymmetries. Conclusions.-E ven in mass screenings, the screening orthopedic examination should be used only in conjunction with an orthopedic history. Some modificatio ns may improve the sensitivity of the screening examination.