Subacromial impingement: palpation vs. impingement tests
In clinical practice, impingement tests are commonly used to detect rotator cuff tendon pathology – in this study however, it is hypothesized that palpation tests may perform better due to their more tendon specific nature. Moreover, they might be more feasible in populations with a limited range of motion.
The diagnostic accuracy of impingement tests and palpation tests was investigated, using musculoskeletal ultrasonography as reference standard. 69 healthy shoulders and 69 shoulders in which subacromial impingement was present were included and examined using: 1) the Neer and Hawkins-Kennedy impingement tests; 2) palpation tests for the supraspinatus, infraspinatus and subscapularis muscle and the tendon of the long head of the biceps; and 3) musculoskeletal ultrasound.
Addition of the supraspinatus and biceps palpation tests to standard physical examination procedures increases its sensitivity: especially the supraspinatus palpation test had a higher sensitivity and accuracy that the common impingement tests. Nevertheless, palpation tests remain highly dependant on the skill of the performer and the validity of ultrasound as reference standard can be questioned: abnormalities are also found in asymptomatic individuals. > From: Toprak et al., Knee Surg Sports Traumatol Arthrosc 21 (2013) 424-429. All rights reserved to Springer-Verlag.
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