Diagnostic value of clinical tests for degenerative rotator cuff disease in medical practice.
OBJECTIVE
To assess the diagnostic value of clinical tests for degenerative rotator cuff disease (DRCD) in medical practice.


METHODS
Patients with DRCD were prospectively included. Eleven clinical tests of the rotator cuff have been done. One radiologist performed ultrasonography (US) of the shoulder. Results of US were expressed as normal tendon, tendinopathy or full-thickness tear (the reference). For each clinical test and each US criteria, sensitivity, specificity, negative predictive value and positive predictive value, accuracy, negative likelihood ratio (NLR) and positive likelihood ratio (PLR) were calculated. Clinical relevance was defined as PLR ≥2 and NLR ≤0.5.


RESULTS
For 35 patients (39 shoulders), Jobe (PLR: 2.08, NLR: 0.31) and full-can (2, 0.5) test results were relevant for diagnosis of supraspinatus tears and resisted lateral rotation (2.42, 0.5) for infraspinatus tears, with weakness as response criteria. The lift-off test (8.50, 0.27) was relevant for subscapularis tears with lag sign as response criteria. Yergason's test (3.7, 0.41) was relevant for tendinopathy of the long head of the biceps with pain as a response criterion. There was no relevant clinical test for diagnosis of tendinopathy of supraspinatus, infraspinatus or subscapularis.


CONCLUSIONS
Five of 11 clinical tests were relevant for degenerative rotator cuff disease.
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France.
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Lasbleiz
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France.
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Quintero
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France.
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Ea
Service de radiologie ostéo-articulaire, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, Paris, France.
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Petrover
Unité de recherche clinique, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, Paris, France.
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Aout
Service de radiologie ostéo-articulaire, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, Paris, France.
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Laredo
Unité de recherche clinique, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, Paris, France.
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Vicaut
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France.
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Bardin
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France.
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Orcel
Service de rhumatologie, groupe hospitalier Lariboisière - Fernand-Widal, AP-HP, université Paris 7, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: johann.beaudreuil@lrb.aphp.fr.
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Beaudreuil
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000150:complications / Q000175:diagnosis; D020069:Shoulder Pain / Q000209:etiology; D052256:Tendinopathy / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography
Clinical tests; Coiffe des rotateurs; Diagnostic value; Full-thickness tear; Rotator cuff; Rupture transfixiante; Shoulder; Tendinopathie; Tendinopathy; Tests cliniques; Valeur diagnostique; Épaule