The validity of 9 physical tests for full-thickness rotator cuff tears after primary anterior shoulder dislocation in ED patients
| Autor: | Chi Kit Yuen, Ka Leung Mok, Pui Gay Kan |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Infraspinatus muscle Sensitivity and Specificity Jobe's test Rotator Cuff Injuries Rotator Cuff Young Adult medicine Humans Sign test False Positive Reactions Rotator cuff Prospective Studies Prospective cohort study False Negative Reactions Aged Aged 80 and over business.industry Shoulder Dislocation Rotator cuff injury Reproducibility of Results General Medicine Middle Aged medicine.disease Confidence interval Surgery medicine.anatomical_structure Emergency Medicine Female Emergency Service Hospital business |
| Zdroj: | The American Journal of Emergency Medicine. 30:1522-1529 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2011.12.022 |
| Popis: | Purpose This study was undertaken to validate the diagnostic values of 9 different physical tests in emergency department patients with primary anterior shoulder dislocation (PASD) to select the best screening test for full-thickness rotator cuff tear (FTRCT) after PASD. Methods A prospective analysis of 49 consecutive patients with x-ray-confirmed PASD was performed. All patients were followed at an average of 6.9 days (ranged from 4 to 10 days) in the emergency department. On the day of follow-up, 9 physical tests (namely, Jobe test, external rotation lag sign test, infraspinatus muscle strength test, dropping test, drop test, liftoff test, internal rotation lag sign test, belly-press test, and belly-off test) followed by shoulder ultrasound scan were performed to detect FTRCT. Results The prevalence of FTRCT after PASD is 37% (95% confidence interval [CI], 24%-52%). Fourteen percent of the patients with PASD were complicated with isolated supraspinatus tendon tear, whereas 22% were complicated with supraspinatus tendon tear combined with subscapularis and/or infraspinatus tendon tear. Jobe test has the highest sensitivity among the 9 physical tests being evaluated. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive test, and likelihood ratio for negative test of Jobe test as a screening test for FTRCT after PASD are 89% (95% CI, 64%-98%), 55% (95% CI, 36%-72%), 53% (95% CI, 35%-71%), 89% (95% CI, 65%-98%), 1.97 (95% CI, 1.29-2.99), and 0.20 (95% CI, 0.05-0.79), respectively. Conclusions The prevalence of FTRCT after PASD is 37% (95% CI, 24%-52%). Jobe test has the highest sensitivity (89% CI, 64%-98%) among the tests. |
| Databáze: | OpenAIRE |
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