Rule It In, Rule It Out
The probability-first handbook of musculoskeletal examination, by Shane Tompson, physiotherapist. Nine body regions, the tests that earn their place, the widely taught ones of limited diagnostic value, and the numbers behind each. Coming in November 2026 as a PDF and a paperback.
Free clinical library
Free to use, no sign-up. Every figure links to the study it came from.
Special tests by region
Over 130 examination tests, with the published sensitivity, specificity and likelihood ratios where the study reports them.
Red flags by region
The serious conditions to screen for before any test, with a source for every row.
The strongest tests
The tests that do real work, ranked by likelihood ratio, to rule in and to rule out.
Probability calculator
What a positive or a negative result does to the chance of a diagnosis.
Teaching cases
Twelve short printable cases for students: a patient, a test, and what each result does to the chance.
For lecturers and librarians
Using the library in teaching, linking from a course or library guide, and how to cite it.
The book
Most examination tests are taught as if they gave yes-or-no answers. They don't. Each one moves the probability of a diagnosis up or down, by an amount that has been measured. Rule It In, Rule It Out puts those measurements on the page, region by region, so a clinician can see which findings really change the picture and which only feel as if they do. It is written for physiotherapists, exercise physiologists, chiropractors, osteopaths, doctors (including orthopaedic surgeons and sports physicians) and students.
More about the book, and the launch list.
Browse the free special tests library: over 130 examination tests with their published accuracy figures.
The newsletter
Rule It In is a monthly evidence letter: five minutes a month on how to examine, and how to decide. Each issue explains a recent study and one test of the month, with a few short practical points.
Read the latest issue · All issues
Free when you confirm your email: a one-page PDF of the strongest special tests to rule in and rule out, with tests that carry a caution flagged separately.
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About Trokos
Trokos is a registered business name of Trokos Health Pty Ltd, ACN 703 339 897, ABN 97 703 339 897. Shane Tompson, a physiotherapist on the Sunshine Coast, Queensland, writes the newsletter and is writing the book.