title: Correlation between physical examination and intraoperative findings in shoulder disease treated by arthroscopy. Statistical analysis of 150 patients.
abstract: BACKGROUND
  Only a few clinical exploratory manoeuvres are truly discriminatory and useful in shoulder disease. The aim of this study is to correlate the physical examination results of the shoulder with the true diagnosis found by arthroscopy.
  
  
  METHODS
  A retrospective case series of 150 patients with the most common surgical conditions of the shoulder. Data were collected on the suspicion of each pathology, the physical examination of the patient, and the actual discovery of the disease during arthroscopic surgery.
  
  
  RESULTS
  The Bankart examination manoeuvres of the lesion show the best results, with a 92.1% positive prediction value (PPV), a 99.1% negative predictive value (NPV), followed by the impingement syndrome, with a PPV of 94.4%, and total cuff rupture with a PPV of 92.3%.Exploration of the superior labrum anterior to posterior (SLAP) lesion had an NPV of 99.1%.
  
  
  CONCLUSIONS
  Physical examination is sufficient to diagnose or rule out Bankart. A positive physical examination provides the complete rupture of the rotator cuff, and requires further studies. The patients suspected of subacromial syndrome only need an NMR if the physical tests are negative. The conclusions drawn from this work can have a significant impact on both cost savings (by reducing forward tests), and saving time in certain cases in which, after appropriate physical examination, surgery may be indicated without losing time in intermediate steps.
authors.affiliation: Servicio de Traumatología y Cirugía Ortopédica, HH. UU. Virgen del Rocío, Sevilla, España. Electronic address: pablogarciaparra@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: García Parra
authors.affiliation: Servicio de Traumatología y Cirugía Ortopédica, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: M
authors.initials: M
authors.lastname: Anaya Rojas
authors.affiliation: Servicio de Traumatología y Cirugía Ortopédica, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: B
authors.initials: B
authors.lastname: Jiménez Bravo
authors.affiliation: Servicio de Medicina Física y Rehabilitación, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: M O
authors.initials: MO
authors.lastname: González Oria
authors.affiliation: Servicio de Reumatología, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: M
authors.initials: M
authors.lastname: Lisbona Muñoz
authors.affiliation: Servicio de Traumatología y Cirugía Ortopédica, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Gil Álvarez
authors.affiliation: Servicio de Traumatología y Cirugía Ortopédica, HH. UU. Virgen del Rocío, Sevilla, España.
authors.forename: P
authors.initials: P
authors.lastname: Cano Luis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000070599:Shoulder Injuries / Q000175:diagnosis* / Q000601:surgery; D012785:Shoulder Joint / Q000601:surgery*
keywords: Análisis estadístico; Arthroscopy; Artroscopia; Exploración física; Hombro; Physical examination; Shoulder; Statistic analysis