The Study: The diagnostic accuracy of the Kemp’s test: a systematic review

The Facts:
a. The authors looked at the literature pertaining to the ability of Kemp’s test to diagnose facet joint pain.

b. Facet joint pain arises “from any structure related to the facet joints.”

c. Kemp’s test is used to diagnose pain in the facet joints.

d. The current “gold standard” for diagnosing facet pain is anesthetic injections to either the facet joints or their nerve supply.

e. The authors searched the literature to determine how accurate the Kemp’s test was in diagnosing facet joint pain.

f. They concluded that:
1. The literature supporting the test is limited.
2. The literature which is available “generally indicates the test has poor diagnostic accuracy.”
3. A negative test may be of some “value in eliminating the facet joint as a source of pain.”

g. They also noted that their search only found five studies that met their inclusion criteria and that “these studies varied in several important aspects of the methods used…” Also only two of these five studies were uncovered by the author’s database search.

Take Home:
The authors concluded Kemp’s test is not diagnostically accurate but may have some value in eliminating the facet joint as a source of pain. Their inclusion criteria allowed for only a very small number of studies to be included for consideration and these studies varied in important aspects of the methods used.

Reviewer’s Comments:
Disappointing, as this is a common test for facet joint pain, but the article is based on a very small number of previous studies. I suggest you read the article and come to your own conclusions regarding your use of this test. It would be nice to see a number of new studies in the future.

Reviewer: Roger Coleman DC

Editor’s Comments: A number of the orthopedic tests most of us learned in college have serious problems in terms of accuracy and reliability. I agree with Dr. Coleman that this is a basic area in which the profession at large could use more information. More studies could help eliminate self deluding practices.

Reference: Stuber K, Lerede C, Kristmanson K, Sajko S, Bruno P. The diagnostic accuracy of the Kemp’s test: a systematic review. J Can Chiropr Assoc.2014;58:258-67.

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/25202153