Clinical evaluation of acromioclavicular joint pathology: sensitivity of a new test.
BACKGROUND
A prospective study was established to assess the sensitivity of the newly described Bell-van Riet (BvR) test for isolated AC pathology, and compare with 4 commonly used clinical tests.


METHODS
The BvR test is essentially the cross-adduction test, with the addition of attempted elevation against resistance. In a positive test, this results in some pain and the inability of the patient to maintain the arm in the adducted and elevated position against resistance. Fifty-eight patients with isolated AC joint symptoms were assessed in random order with the BvR test and 4 other tests. A corticosteroid and local anaesthetic injection was administered into the AC joint space. The BvR test and 4 other tests were then repeated following the injection. After the injection, a symptom free clinical examination was used as a measure of truly positive tests.


RESULTS
The BvR test showed a sensitivity of 98%. All 4 other tests were less sensitive.


CONCLUSIONS
The BvR test is a highly sensitive test in patients presenting with isolated AC related symptoms, and demonstrates AC joint pathology better than other accepted tests.
van Riet
Roger P
RP
Department of Orthopedic Surgery and Traumatology, Monica Hospital, Deurne (Antwerp), Belgium. rogervanriet@hotmail.com
Bell
Simon N
SN
D000173:Acromioclavicular Joint; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012680:Sensitivity and Specificity; D020069:Shoulder Pain / Q000209:etiology; D055815:Young Adult