Article

OBJECTIVES: 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.
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Langue : ANGLAIS ; FRANCAIS