Auscultatory Patellar-Pubic Percussion Test

What is the "Auscultatory Patellar-Pubic Percussion Test" used for?

• The ausculatory patellar-pubic percussion test is used when there is a suspicion of occult hip fracture.

How to perform the "Auscultatory Patellar-Pubic Percussion Test"?

• The patient is positioned in supine, and the clinician places the head of a stethoscope over the pubic symphysis.
• With the lower extremities extended and positioned symmetrically, the clinician taps (percusses) each patella with a finger or reflex hammer and compares the generated sound.

What is the positive result?

• The percussion note should have symmetrical quality and intensity of sound.
• Any bony disruption along the conduction path (femur) will result in a diminished or muffled sound intensity of a duller quality.

Test Accuracy

• Sensitivity: 96%
• Specificity: 76%

References

• Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
• Adams SL, Yarnold PR. Clinical use of the patellar-pubic percussion sign in hip trauma. Am J Emerg Med. 1997 Mar;15(2):173-5. doi: 10.1016/s0735-6757(97)90095-4. PMID: 9115523.
• https://www.verenso.nl/magazine-april-2020/no-2-april-2020/wetenschap/cat