Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain
In literature, localized AC joint tenderness, the O’Brien’s/ Active Compression test, the cross-body adduction test and the Hawkins-Kennedy test are reported to have moderate to high sensitivity and specificity values for establishing the diagnosis of AC joint pain. However, most studies have been conducted in secondary care settings – therefore, the population included may differ substantially from that presenting to primary care practices.
The purpose of the present study was to determine the diagnostic accuracy of the “traditional” AC joint tests (mentioned above) and that of other clinical examination findings, and compare between those to identify the most valid diagnostic criteria for AC joint problems in a primary care setting.
It was found that traditional AC joint test had only little diagnostic value, and that a combination of other clinical examination findings (repetitive mechanism of pain onset; absence of referred pain below the elbow; a swollen AC joint; absence of pain provocation during passive shoulder abduction and external rotation) was able to diagnose AC joint pain more accurately. > From: Cadogan et al., BMC Musculoskelet Disord 14 (2013) 156. Open Access article distributed under the terms of the Creative Commons Attribution License.
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