Diagnostic value of tests for degenerative RC disease
Most studies investigating diagnostic value of clinical shoulder tests are conducted in surgical departments, and therefore the patients and results might not be reflecting the population seen in primary care. In order to determine the tests with the best diagnostic performance for degenerative rotator cuff disease (tendinopathy or a tear), 11 tests were investigated, using ultrasonography as reference.
In 48 shoulders, the following tests were performed: the Jobe and full can tests (supraspinatus), the hornblower’s and drop signs, gate test, Patte’s test and resisted external rotation (infraspinatus), the lift-off and belly press tests (subscapularis) and the palm up and Yergason’s tests (long head of the biceps).
It was found that the Jobe and full can tests, the resisted external rotation, the belly press and lift-off tests were clinical relevance – based on likelihood ratios –, provided that weakness was the response criterion. Not so surprisingly, pain as a clinical sign was found to be of less diagnostic value and accordingly, most tests did not have clinical relevance in establishing the diagnosis of tendinopathy.
> From: Lasbleiz et al., Ann Phys Med Rehabil 57 (2014) 228-243. All rights reserved to All rights reserved to Elsevier Masson SAS. Click here for the Pubmed summary.