Summary
ERCUSSION of the chest is thought to be insensitive in detecting small or deeply situated chest lesions. A newer technique, ausculatory percussion, has been reported as having a far higher sensitivity. In a controlled blind study the diagnostic value of conventional chest percussion compared with ausculatory percussion was defined using the chest x-ray as a gold standard. The prevalence of disease in 100 lung fields was 26%.
The majority of lesions were not detected by either technique resulting in very low sensitivities of 15.4% for conventional percussion and 19.2% for ausculatory percussion. A positive result with ausculatory percussion was twice as likely to be false as true (positive predictive value 31.2%). The technique did not add to the diagnostic value of conventional percussion. Both techniques have major limitations. Patients with suspected lung disease still require chest x-ray examination if percussion is normal.
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References
Ogilvie, C. Chamberlain’s Symptoms and Signs in Clinical Medicine. 10th ed. Wright and Sons Ltd., Bristol, England. 1980: 183.
Guarino, J. R. Ausculatory percussion of the chest. Lancet 1980: i, 1332–4.
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Bourke, S., Nunes, D., Stafford, F. et al. Percussion of the chest re-visited: A comparison of the diagnostic value of ausculatory and conventional chest percussion. I.J.M.S. 158, 82–84 (1989). https://doi.org/10.1007/BF02942111
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DOI: https://doi.org/10.1007/BF02942111