Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder
Objective: High resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinical examination often does not allow an exact diagnosis. The aim of this study was to compare the fi ndings of clinical examination an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2015-03-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-15-no-60/correlation-of-findings-in-clinical-and-high-resolution-ultrasonography-examinations-of-the-painful-shoulder?aid=320 |
| _version_ | 1818174870937141248 |
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| author | Raphael Micheroli Diego Kyburz Adrian Ciurea Beat Dubs Martin Toniolo Samuel Pascal Bisig Giorgio Tamborrini |
| author_facet | Raphael Micheroli Diego Kyburz Adrian Ciurea Beat Dubs Martin Toniolo Samuel Pascal Bisig Giorgio Tamborrini |
| author_sort | Raphael Micheroli |
| collection | DOAJ |
| description | Objective: High resolution ultrasonography is a non-painful and non-invasive imaging
technique which is useful for the assessment of shoulder pain causes, as clinical
examination often does not allow an exact diagnosis. The aim of this study was to
compare the fi ndings of clinical examination and high resolution ultrasonography
in patients presenting with painful shoulder. Methods: Non-interventional observational
study of 100 adult patients suffering from unilateral shoulder pain. Exclusion
criteria were shoulder fractures, prior shoulder joint surgery and shoulder injections
in the past month. The physicians performing the most common clinical shoulder
examinations were blinded to the results of the high resolution ultrasonography and
vice versa. Results: In order to detect pathology of the m. supraspinatus tendon, the
Hawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas
the Jobe supraspinatus test showed the highest specifi city (0.55). To identify m. subscapularis
tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas
the belly press test showed the higher specifi city (0.72). The infraspinatus test showed
a high sensitivity (0.90) and specifi city (0.74). All AC tests (painful arc IIa, AC joint
tendernessb, cross body adduction stress testc
) showed high specifi cities (a0.96, b0.99, c
0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity
(0.47) and the Yergason test the highest specifi city (0.88). Conclusion: Knowledge
of sensitivity and specifi city of various clinical tests is important for the interpretation
of clinical examination test results. High resolution ultrasonography is needed in most
cases to establish a clear diagnosis. |
| first_indexed | 2024-12-11T19:51:17Z |
| format | Article |
| id | doaj.art-094e84da83214274a2d5480a17fc1018 |
| institution | Directory Open Access Journal |
| issn | 2084-8404 2451-070X |
| language | English |
| last_indexed | 2024-12-11T19:51:17Z |
| publishDate | 2015-03-01 |
| publisher | Sciendo |
| record_format | Article |
| series | Journal of Ultrasonography |
| spelling | doaj.art-094e84da83214274a2d5480a17fc10182022-12-22T00:52:46ZengSciendoJournal of Ultrasonography2084-84042451-070X2015-03-011560294410.15557/JoU.2015.0003Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulderRaphael Micheroli0Diego Kyburz1Adrian Ciurea2Beat Dubs3Martin Toniolo4Samuel Pascal Bisig5Giorgio Tamborrini6Faculty of Medicine, University of Zurich, Switzerland Department of Rheumatology, University Hospital of Basel, SwitzerlandDepartment of Rheumatology, University Hospital of Zurich, SwitzerlandSonography Institute Glattpark, Zurich, SwitzerlandDepartment of Rheumatology, University Hospital of Zurich, SwitzerlandSwiss Federal Institute of Technology, Zurich, SwitzerlandUltrasound Center, Department of Rheumatology, Bethesda Hospital Basel, SwitzerlandObjective: High resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinical examination often does not allow an exact diagnosis. The aim of this study was to compare the fi ndings of clinical examination and high resolution ultrasonography in patients presenting with painful shoulder. Methods: Non-interventional observational study of 100 adult patients suffering from unilateral shoulder pain. Exclusion criteria were shoulder fractures, prior shoulder joint surgery and shoulder injections in the past month. The physicians performing the most common clinical shoulder examinations were blinded to the results of the high resolution ultrasonography and vice versa. Results: In order to detect pathology of the m. supraspinatus tendon, the Hawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas the Jobe supraspinatus test showed the highest specifi city (0.55). To identify m. subscapularis tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas the belly press test showed the higher specifi city (0.72). The infraspinatus test showed a high sensitivity (0.90) and specifi city (0.74). All AC tests (painful arc IIa, AC joint tendernessb, cross body adduction stress testc ) showed high specifi cities (a0.96, b0.99, c 0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity (0.47) and the Yergason test the highest specifi city (0.88). Conclusion: Knowledge of sensitivity and specifi city of various clinical tests is important for the interpretation of clinical examination test results. High resolution ultrasonography is needed in most cases to establish a clear diagnosis.http://jultrason.pl/index.php/issues/volume-15-no-60/correlation-of-findings-in-clinical-and-high-resolution-ultrasonography-examinations-of-the-painful-shoulder?aid=320ultrasonographyphysical examinationshoulderpaindiagnosis |
| spellingShingle | Raphael Micheroli Diego Kyburz Adrian Ciurea Beat Dubs Martin Toniolo Samuel Pascal Bisig Giorgio Tamborrini Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder Journal of Ultrasonography ultrasonography physical examination shoulder pain diagnosis |
| title | Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| title_full | Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| title_fullStr | Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| title_full_unstemmed | Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| title_short | Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| title_sort | correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder |
| topic | ultrasonography physical examination shoulder pain diagnosis |
| url | http://jultrason.pl/index.php/issues/volume-15-no-60/correlation-of-findings-in-clinical-and-high-resolution-ultrasonography-examinations-of-the-painful-shoulder?aid=320 |
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