Diagnosis of soft tissue disorders of the upper limb

We conducted a comprehensive computerised literature review in order to derive a workable examination schedule. In two separate studies in a hospital clinic and a general population sample, we tested its feasibility for use by trained research nurses and its reproducibility and face validity in two different populations. The between-observer reproducibility of physical signs in the hospital clinic was good to excellent (kappa coefficients 0.66-1.0 for most categorical variables). In the general population, between-observer reliability of physical signs was generally less good, but the reliability of agreement of specific diagnoses remained acceptable, with a median kappa coefficient of 0.66 (range 0.21-0.93). When compared against the standard of physicians’ diagnoses, the schedule was sensitive (58-87%) and highly specific (84-100%). Conclusion: The Southampton examination schedule represents a feasible, and reproducible tool with face validity; suitable for use in future research into upper limb disorders, and has the backing of UK consensus criteria