Diagnostic value of clinical tests for degenerative rotator cuff disease in medical practice

Abstract Objectives To assess the diagnostic value of clinical tests for degenerative rotator cuff disease (DRCD) in medical practice. Methods Patients with DRCD were prospectively included. Eleven clinical tests of the rotator cuff have been done. One radiologist performed ultrasonography (US) of t...

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Bibliographic Details
Published in:Annals of physical and rehabilitation medicine 2014-06, Vol.57 (4), p.228-243
Main Authors: Lasbleiz, S, Quintero, N, Ea, K, Petrover, D, Aout, M, Laredo, J.D, Vicaut, E, Bardin, T, Orcel, P, Beaudreuil, J
Format: Article
Language:English
Subjects:
Aged
Clinical tests
Coiffe des rotateurs
Cross-Sectional Studies
Diagnostic value
Female
Full-thickness tear
Humans
Internal Medicine
Male
Middle Aged
Physical Examination
Physical Medicine and Rehabilitation
Predictive Value of Tests
Rotator cuff
Rotator Cuff - diagnostic imaging
Rotator Cuff Injuries
Rupture - complications
Rupture - diagnosis
Rupture transfixiante
Shoulder
Shoulder Pain - etiology
Tendinopathie
Tendinopathy
Tendinopathy - complications
Tendinopathy - diagnosis
Tendinopathy - diagnostic imaging
Tests cliniques
Ultrasonography
Valeur diagnostique
Épaule
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Summary:Abstract Objectives To assess the diagnostic value of clinical tests for degenerative rotator cuff disease (DRCD) in medical practice. Methods Patients with DRCD were prospectively included. Eleven clinical tests of the rotator cuff have been done. One radiologist performed ultrasonography (US) of the shoulder. Results of US were expressed as normal tendon, tendinopathy or full-thickness tear (the reference). For each clinical test and each US criteria, sensitivity, specificity, negative predictive value and positive predictive value, accuracy, negative likelihood ratio (NLR) and positive likelihood ratio (PLR) were calculated. Clinical relevance was defined as PLR ≥2 and NLR ≤0.5. Results For 35 patients (39 shoulders), Jobe (PLR: 2.08, NLR: 0.31) and full-can (2, 0.5) test results were relevant for diagnosis of supraspinatus tears and resisted lateral rotation (2.42, 0.5) for infraspinatus tears, with weakness as response criteria. The lift-off test (8.50, 0.27) was relevant for subscapularis tears with lag sign as response criteria. Yergason's test (3.7, 0.41) was relevant for tendinopathy of the long head of the biceps with pain as a response criterion. There was no relevant clinical test for diagnosis of tendinopathy of supraspinatus, infraspinatus or subscapularis. Conclusions Five of 11 clinical tests were relevant for degenerative rotator cuff disease.
ISSN:1877-0657
1877-0665
DOI:10.1016/j.rehab.2014.04.001