[Reliability of clinical examination of the shoulder in comparison with arthroscopy. A prospective study].
The results of clinical shoulder examination including 20 special tests were compared with subsequent arthroscopic findings in 45 patients. The sensitivity of the clinical diagnosis was 73%. Impingement syndrome was correctly diagnosed in 19 of 22 cases (86%), rotator cuff tears in 7 of 9 cases (78%). The highest sensitivity for stage II impingement was found for the supraspinatus test (85%) and the lift-up test (92%); the sensitivity of these tests for rotator cuff tears was 100% and 89% respectively. Differentiation between impingement syndrome with and without rotator cuff tear by one of these tests alone was not possible because of their low positive predictive values (26% and 56%). In contrast, in 90% of patients with negative rotator tests the rotator cuff was complete, while the negative predictive value of the supraspinatus test was 100%. Instability was confirmed in only 53% of cases; the Leffert test had the highest positive predictive value (73%). In conclusion, the clinical diagnosis of a shoulder lesion cannot reliably be achieved by single tests; rather overall evaluation by an experienced clinician is necessary.
Ure
B M
BM
II. Lehrstuhl für Chirurgie, Universität Köln.
Tiling
T
T
Kirchner
R
R
Rixen
D
D
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000601:surgery; D000070599:Shoulder Injuries
Zuverlässigkeit der klinischen Untersuchung der Schulter im Vergleich zur Arthroskopie. Eine prospektive Studie.