Rule It In, Rule It Out
A probability-first handbook of musculoskeletal examination, by Shane Tompson, physiotherapist. Coming in late 2026 as a PDF and a paperback.
What the book does
Each chapter starts from the questions a clinician actually faces in the clinic, then shows how much each examination test changes the answer. For every test with published figures you get how to do it, what counts as positive, how far a positive or negative result moves the likelihood of the diagnosis, and, where it has been studied, whether combining tests helps. Tests that are famous but do little are named as such.
It is written for physiotherapists, exercise physiologists, chiropractors, osteopaths, doctors (including orthopaedic surgeons and sports physicians) and students.
Nine regions, forty-three clinical questions
Two from each chapter:
- 1. The shoulder: Is it the neck or the shoulder? · A painful cuff, or a torn one?
- 2. The neck: Is it a nerve root, or referred pain? · Is this myelopathy? Which signs actually matter
- 3. The thoracic spine and chest wall: Chest-wall pain, or the heart, lungs or aorta? · Mechanical mid-back pain, or an osteoporotic fracture?
- 4. The low back and pelvis: Radicular leg pain, or referred pain? · Cauda equina and serious pathology: when to send, and how fast
- 5. The hip and groin: Is it the hip joint, or the lateral hip? · Groin pain in a runner: rule out the stress fracture first
- 6. The knee: Is the ACL torn? · Is it the meniscus?
- 7. The elbow: After a fall: does this elbow need an X-ray? · Is the distal biceps torn?
- 8. The wrist and hand: Is it carpal tunnel syndrome, and which test should I trust? · After a fall on the outstretched hand: when does the scaphoid need imaging?
- 9. The ankle and foot: Rolled ankle: lateral ligament sprain or high ankle sprain? · Is the Achilles torn?
The free test library already has the published figures for 111 examination tests.
How it is written
The book is drafted with AI assistance. Every figure is checked against its source wherever the paper can be obtained, and each chapter is checked independently before publication. Corrections after publication will be listed and dated on this site.
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