Nye et al reported a clinical prediction rule for identifying bone stress injury in a lower extremity. The authors are from Fort Belvoir Community Hospital, Travis Air Force Base, JBSA-Lackland, Uniformed Services University of the Health Sciences and the Orthopaedic Center (Rockville).
Parameters:
(1) history of stress fracture
(2) history of pes cavus
(3) increased volume of walking/running
(4) focal bony tenderness
Parameter
Finding
Points
history of stress fracture
no
0
yes
2
history of pes cavus
no
0
yes
2
increased volume of walking or running
no
0
yes
1
focal bony tenderness
no
0
yes
3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 3 is 97.5% sensitive and 54.2% specific for a bone stress injury, with a negative predictive value of 98.2%.
