Sensitivity for palpating lumbopelvic soft- tissues and bony landmarks and its associated factors: A single-blinded diagnostic accuracy study

Abstract

BACKGROUND:

Evidence on the diagnostic performance of palpatory methods and possible confounding factors is scarce.

OBJECTIVES:

To examine the sensitivity of palpatory methods for location of lumbopelvic landmarks and to assess its association with personal characteristics.

METHODS:

Eighty-three participants (41 men, 55.6 (16.5) years, 25.9 (4.8) kg/m ${}^2$ [mean (SD)]) were enrolled in this single-blinded study. Fourteen body and softy-tissue landmarks were sequentially palpated from the spinous process of L4 to the ischial tuberosity. CT-scan images were used to assess what landmark was located.

RESULTS:

Sensitivity for location was in range 22–86% for soft-tissues and 26–69% for bony landmarks. Reduction in sensitivity was observed from the quadratus lumborum to the inferior and lateral angle of the sacrum (86–26% and 75–33%, left and right sides, respectively). Palpations of L4 and L5 spinous processes were systematically more cephalic than other landmarks. Gender was weakly correlated to almost all landmarks ( $r_{pb}=$ 0.333 or weaker). Body mass index was weakly correlated to the accurate location of ILAS and quadratus lumborum, great trochanter, PSIS, and piriformis ( $r_{pb}=-$ 0.307 or weaker).

CONCLUSIONS:

Systematic and propagation errors were present using sequential palpatory methods. Palpation in men was more sensitive and higher BMI was associated with lower sensitivity for lumbopelvic landmarks.