Editing Tuning fork (section)

===Medical and scientific uses===
[[Image:Tuning fork oscillator frequency standard.jpg|thumb|upright|1&nbsp;kHz tuning fork [[vacuum tube]] [[electronic oscillator|oscillator]] used by the U.S. National Bureau of Standards (now [[National Institute of Standards and Technology|NIST]]) in 1927 as a frequency standard.]]

Alternatives to the common A=440 standard include [[Scientific pitch|philosophical or scientific pitch]] with standard pitch of C=512. According to [[John William Strutt, 3rd Baron Rayleigh|Rayleigh]], physicists and acoustic instrument makers used this pitch.<ref>{{cite book|last=Rayleigh|first=J. W. S.|title=The Theory of Sound|url=https://archive.org/details/theoryofsoundvol000709mbp|url-access=limited|year=1945|publisher=Dover|location=New York|isbn=0-486-60292-3|page=[https://archive.org/details/theoryofsoundvol000709mbp/page/n54 9]}}</ref> The tuning fork [[John Shore (trumpeter)|John Shore]] gave to [[George Frideric Handel]] produces C=512.<ref>{{cite journal |pmc=1291142 |title=The origin of the tuning fork |first1=RC |last1=Bickerton |first2=GS |last2=Barr |journal=[[Journal of the Royal Society of Medicine]] |volume=80 |issue=12 |pages=771–773 |date=December 1987 |pmid=3323515|doi = 10.1177/014107688708001215}}</ref>

Tuning forks, usually C512, are used by medical practitioners to assess a patient's hearing. This is most commonly done with two exams called the [[Weber test]] and [[Rinne test]], respectively. Lower-pitched ones, usually at C128, are also used to check vibration sense as part of the examination of the peripheral nervous system.<ref>{{cite book |last1=Bickley |first1=Lynn |last2=Szilagyi |first2=Peter |date=2009 |title=Bates' guide to the physical examination and history taking |edition=10th |location=Philadelphia, PA |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-8058-2}}</ref>

[[orthopedic surgery|Orthopedic surgeons]] have explored using a tuning fork (lowest frequency C=128) to assess injuries where bone fracture is suspected. They hold the end of the vibrating fork on the skin above the suspected fracture, progressively closer to the suspected fracture. If there is a fracture, the [[periosteum]] of the bone vibrates and fires [[nociceptor]]s (pain receptors), causing a local sharp pain.{{citation needed|date=April 2016}} This can indicate a fracture, which the practitioner refers for medical X-ray. The sharp pain of a local sprain can give a false positive.{{citation needed|date=April 2016}} Established practice, however, requires an X-ray regardless, because it's better than missing a real fracture while wondering if a response means a sprain. A systematic review published in 2014 in [[BMJ Open]] suggests that this technique is not reliable or accurate enough for clinical use.<ref>{{cite journal |url= |title=Is there sufficient evidence for tuning fork tests in diagnosing fractures? A systematic review |first1=Kayalvili |last1=Mugunthan |first2=Jenny |last2=Doust |first3=Bodo |last3=Kurz |first4=Paul |last4=Glasziou |date=4 August 2014 |journal=[[BMJ Open]] |volume=4 |issue=8 |pages=e005238 |doi=10.1136/bmjopen-2014-005238|pmid=25091014 |pmc=4127942 }} {{open access}}</ref>