title: Combining orthopedic special tests to improve diagnosis of shoulder pathology.
abstract: The use of orthopedic special tests (OSTs) to diagnose shoulder pathology via the clinical examination is standard in clinical practice. There is a great deal of research on special tests but much of the research is of a lower quality implying that the metrics from that research, sensitivity, specificity, and likelihood ratios, is likely to vary greatly in the hands of different clinicians and in varying practice environments. A way to improve the clinical diagnostic process is to cluster OSTs and to use these clusters to either rule in or out different pathologies. The aim of the article is to review the best OST clusters, examine the methodology by which they were derived, and illustrate, with a case study, the use of these OST clusters to arrive at a pathology-based diagnosis.
authors.affiliation: High Point University, Department of Physical Therapy, High Point, NC 27262, USA. Electronic address: ehegedus@highpoint.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hegedus
authors.affiliation: Physical Therapy Program, Duke University, Durham, NC, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Cook
authors.affiliation: Physiotherapy, University of Hertfordshire, Department of Allied Health Professions and Midwifery, School of Health and Social Work, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Lewis
authors.affiliation: High Point University, Department of Physical Therapy, High Point, NC 27262, USA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Wright
authors.affiliation: Shoulder, Elbow & Sports Center, Konkuk University, Seoul, South Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Park
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D019637:Orthopedic Procedures / Q000592:standards*; D010808:Physical Examination / Q000592:standards*; D058996:Quality Improvement; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries
keywords: Diagnosis; Likelihood ratios; Shoulder