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Research project

Diagnosing hand and wrist pathologies in primary care

Status: Ongoing (2015 - 2022)

Despite the high prevalence of hand and wrist complaints in primary care, there is little knowledge on the accuracy and feasibility of the diagnostic process by general practitioners.

What we do

About our project

Background
The standard diagnostic work-up for hand and wrist complaints in primary care consists of history taking, physical examination and imaging if needed, but the supporting evidence for this work-up is limited.

Hypothesis
The is a knowledge gap on the diagnosis and treatment of hand and wrist complaints in primary care.

Methods
The current project consists of 4 work packages:

  1. a systematic literature search for the accuracy of diagnostic tests for fractures and ligament injuries in the hand and wrist.
  2. validation of the Dutch version of the Patient Rated Wrist/Hand Evaluation (PRWHE-DLV) questionnaire in Dutch primary care patients.
  3. evaluation of the prevalence of structural abnormalities and the course of symptoms in patients referred from primary care for radiography of the hand/wrist.
  4. a Delphi study to develop a consensus-based recommendation of history taking and physical examination tests for the diagnostic work-up of patients with hand and wrist complaints.

Our research focus

Primary outcome
Providing evidence-based recommendation for the prognosis and diagnosis of hand an d wrist complaints in primary care.

Collaborations

Reinier de Graaf Gasthuis, Dept. Radiology

Publications

Krastman P, Mathijssen NMC, Bierma-Zeinstra SMA, Kraan GA, Runhaar J. Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update. BMJ Open. 2020 Nov 5;10(11):e037810. doi: 10.1136/bmjopen-2020-037810.

Krastman P, Mathijssen NM, Bierma-Zeinstra SMA, Kraan G, Runhaar J. Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update. BMC Musculoskelet Disord. 2020 Jan 7;21(1):12. doi: 10.1186/s12891-019-2988-z.

Our team

Dr. J. Runhaar (co-promotor), j.runhaar@erasmusmc.nl
P. Krastman, MD, wetenschap@dezorghoek.nl
Dr. G. Kraan, G.Kraan@rhoc.nl
Dr. N. Mathijssen, N.Mathijssen@rhoc.nl
Prof. S.M.A. Bierma-Zeinstra (promotor), s.bierma-zeinstra@erasmusmc.nl

Contact addresses for the project: p.krastman@erasmusmc.nl and wetenschap@dezorghoek.nl.