Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

Autor: Micheroli, Raphael, Kyburz, Diego, Ciurea, Adrian, Dubs, Beat, Toniolo, Martin, Pascal Bisig, Samuel, Tamborrini, Giorgio
Rok vydání: 2016
Předmět:
Popis: Objective: High resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinicalexamination often does not allow an exact diagnosis. The aim of this study was to compare the fi ndings of clinical examination and high resolution ultrasonographyin patients presenting with painful shoulder. Methods: Non-interventional observational study of 100 adult patients suffering from unilateral shoulder pain. Exclusioncriteria were shoulder fractures, prior shoulder joint surgery and shoulder injections in the past month. The physicians performing the most common clinical shoulderexaminations were blinded to the results of the high resolution ultrasonography and vice versa. Results: In order to detect pathology of the m. supraspinatus tendon, theHawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas the Jobe supraspinatus test showed the highest specifi city (0.55). To identify m. subscapularis tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas the belly press test showed the higher specifi city (0.72). The infraspinatus test showed a high sensitivity (0.90) and specifi city (0.74). All AC tests (painful arc IIa, AC joint tendernessb, cross body adduction stress testc) showed high specifi cities (a0.96, b0.99, c0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity (0.47) and the Yergason test the highest specifi city (0.88). Conclusion: Knowledge of sensitivity and specifi city of various clinical tests is important for the interpretation of clinical examination test results. High resolution ultrasonography is needed in most cases to establish a clear diagnosis.
Databáze: OpenAIRE