The diagnostic value of the combination of clinical tests for the diagnosis of supraspinatus tendon tears

Abstract

CONTEXT: A large number of special tests have been described to examine the shoulder. It is unknown which combination of clinical tests might be optimal for the diagnosis of rotator cuff tears. AIMS OF OUR STUDY: To estimate the diagnostic accuracy of history and clinical tests and to find out which combination of clinical tests is best in diagnosing supraspinatus tendon tears. SETTINGS AND DESIGN: Diagnostic test accuracy study. METHODOLOGY: One hundred and thirty-four patients with shoulder pain were evaluated with history-taking and clinical tests and magnetic resonance imaging of the shoulder. STATISTICAL ANALYSES: Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratios were calculated with a 2 × 2 table. RESULTS: The combination of Neer test, painful arc test, and full can test yielded 100% sensitivity and 100% specificity in diagnosing supraspinatus tears of any type. CONCLUSIONS: Our study shows that individual clinical tests have moderate diagnostic value for the diagnosis of supraspinatus tears. Diagnostic value improves significantly when clinical tests are combined together. Neer test, painful arc test, and full can test form the best combination in diagnosing supraspinatus tears of any type.

Keywords

• Clinical tests
• diagnostic accuracy
• magnetic resonance imaging
• supraspinatus tendon tears