Accuracy of physical examination in subacromial impingement syndrome
Objective. Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standar...
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| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2008-05, Vol.47 (5), p.679-683 |
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| container_title | Rheumatology (Oxford, England) |
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| creator | Silva, L. Andréu, J. L. Muñoz, P. Pastrana, M. Millán, I. Sanz, J. Barbadillo, C. Fernández-Castro, M. |
| description | Objective. Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standard in the diagnosis of SIS. The aim of this study is to evaluate the accuracy of the PE in the diagnosis of SIS and/or subacromial–subdeltoid bursitis (SSB) confirmed by MRI. Methods. Consecutive outpatients with an episode of shoulder pain were prospectively included in the study. They were examined by a rheumatologist and, within 3 days, an MRI was done. Sensitivity, specificity, positive and negative predictive values, and accuracy of PE manoeuvres were calculated using a 2 × 2 table. Results. Fourteen males and 16 females were included. All the tests exhibited acceptable sensitivity. As a result Yocum manoeuvre was considered the most sensitive and most accurate for SIS. With regard to SSB, the Gerber test was the most sensitive. The majority of the PE manoeuvres showed low specificity. Conclusions. Most PE manoeuvres identify reasonably well subacromial impingement of the shoulder, although, in general, they have low specificity. The Yocum test has the best sensitivity and precision. Our data suggest that imaging techniques should be recommended to better define shoulder lesions. |
| doi_str_mv | 10.1093/rheumatology/ken101 |
| format | Article |
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L. ; Muñoz, P. ; Pastrana, M. ; Millán, I. ; Sanz, J. ; Barbadillo, C. ; Fernández-Castro, M.</creator><creatorcontrib>Silva, L. ; Andréu, J. L. ; Muñoz, P. ; Pastrana, M. ; Millán, I. ; Sanz, J. ; Barbadillo, C. ; Fernández-Castro, M.</creatorcontrib><description>Objective. Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standard in the diagnosis of SIS. The aim of this study is to evaluate the accuracy of the PE in the diagnosis of SIS and/or subacromial–subdeltoid bursitis (SSB) confirmed by MRI. Methods. Consecutive outpatients with an episode of shoulder pain were prospectively included in the study. They were examined by a rheumatologist and, within 3 days, an MRI was done. Sensitivity, specificity, positive and negative predictive values, and accuracy of PE manoeuvres were calculated using a 2 × 2 table. Results. Fourteen males and 16 females were included. All the tests exhibited acceptable sensitivity. As a result Yocum manoeuvre was considered the most sensitive and most accurate for SIS. With regard to SSB, the Gerber test was the most sensitive. The majority of the PE manoeuvres showed low specificity. Conclusions. Most PE manoeuvres identify reasonably well subacromial impingement of the shoulder, although, in general, they have low specificity. The Yocum test has the best sensitivity and precision. Our data suggest that imaging techniques should be recommended to better define shoulder lesions.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/ken101</identifier><identifier>PMID: 18375403</identifier><identifier>CODEN: BJRHDF</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Clinical evaluation ; Diseases of the osteoarticular system ; Female ; Humans ; Juxtaarticular diseases. Extraarticular rhumatism ; Likelihood Functions ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Miscellaneous. Osteoarticular involvement in other diseases ; MRI ; Painful shoulder ; Physical Examination - methods ; Range of Motion, Articular ; Sensitivity and Specificity ; Shoulder Impingement Syndrome - diagnosis ; Shoulder Joint - pathology ; Subacromial impingement syndrome ; Subacromial–subdeltoid bursitis</subject><ispartof>Rheumatology (Oxford, England), 2008-05, Vol.47 (5), p.679-683</ispartof><rights>The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org 2008</rights><rights>2008 INIST-CNRS</rights><rights>The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-7d1542c1a803d54fc9ec712d51dbb78f8bc147e136456f9542dc6dd17dc1cb603</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20282738$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18375403$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Silva, L.</creatorcontrib><creatorcontrib>Andréu, J. L.</creatorcontrib><creatorcontrib>Muñoz, P.</creatorcontrib><creatorcontrib>Pastrana, M.</creatorcontrib><creatorcontrib>Millán, I.</creatorcontrib><creatorcontrib>Sanz, J.</creatorcontrib><creatorcontrib>Barbadillo, C.</creatorcontrib><creatorcontrib>Fernández-Castro, M.</creatorcontrib><title>Accuracy of physical examination in subacromial impingement syndrome</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>Objective. Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standard in the diagnosis of SIS. The aim of this study is to evaluate the accuracy of the PE in the diagnosis of SIS and/or subacromial–subdeltoid bursitis (SSB) confirmed by MRI. Methods. Consecutive outpatients with an episode of shoulder pain were prospectively included in the study. They were examined by a rheumatologist and, within 3 days, an MRI was done. Sensitivity, specificity, positive and negative predictive values, and accuracy of PE manoeuvres were calculated using a 2 × 2 table. Results. Fourteen males and 16 females were included. All the tests exhibited acceptable sensitivity. As a result Yocum manoeuvre was considered the most sensitive and most accurate for SIS. With regard to SSB, the Gerber test was the most sensitive. The majority of the PE manoeuvres showed low specificity. Conclusions. Most PE manoeuvres identify reasonably well subacromial impingement of the shoulder, although, in general, they have low specificity. The Yocum test has the best sensitivity and precision. Our data suggest that imaging techniques should be recommended to better define shoulder lesions.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Clinical evaluation</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Humans</subject><subject>Juxtaarticular diseases. Extraarticular rhumatism</subject><subject>Likelihood Functions</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>MRI</subject><subject>Painful shoulder</subject><subject>Physical Examination - methods</subject><subject>Range of Motion, Articular</subject><subject>Sensitivity and Specificity</subject><subject>Shoulder Impingement Syndrome - diagnosis</subject><subject>Shoulder Joint - pathology</subject><subject>Subacromial impingement syndrome</subject><subject>Subacromial–subdeltoid bursitis</subject><issn>1462-0324</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1r3yAUh2V0rC_bJxiMUNju0no0UXNZ2vVldOxiG4zeiFHT2iaaaQLNt68lf_4tu9qVB31-53gehD4CPgLc0ON4Z-dBTaEPt8vxg_WA4Q3ag4qRElNKdrY1qXbRfkr3GOMaqHiHdkFQXleY7qGzE63nqPRShK4Y75bktOoL-6gG59Xkgi-cL9LcKh3D4PKTG0bnb-1g_VSkxZt8bd-jt53qk_2wOQ_Q7_Ovv04vy-sfF1enJ9elrgSZSm6grogGJTA1ddXpxmoOxNRg2paLTrQaKm6BsqpmXZNZo5kxwI0G3TJMD9CXte8Yw9_ZpkkOLmnb98rbMCfJGiAgWJPBw3_A-zBHn_8moalZzYGRDNEVyqulFG0nx-gGFRcJWD4blq8Ny9VwTn3atJ7bwZqXzEZpBj5vAJWyyy4qr13acgQTQTgVmTtauTCP_zm5XAMuTfZxG1HxQTKeh8vLPzfygvw8vzn7juU3-gTx56iY</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Silva, L.</creator><creator>Andréu, J. L.</creator><creator>Muñoz, P.</creator><creator>Pastrana, M.</creator><creator>Millán, I.</creator><creator>Sanz, J.</creator><creator>Barbadillo, C.</creator><creator>Fernández-Castro, M.</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20080501</creationdate><title>Accuracy of physical examination in subacromial impingement syndrome</title><author>Silva, L. ; Andréu, J. L. ; Muñoz, P. ; Pastrana, M. ; Millán, I. ; Sanz, J. ; Barbadillo, C. ; Fernández-Castro, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-7d1542c1a803d54fc9ec712d51dbb78f8bc147e136456f9542dc6dd17dc1cb603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Clinical evaluation</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Humans</topic><topic>Juxtaarticular diseases. Extraarticular rhumatism</topic><topic>Likelihood Functions</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>MRI</topic><topic>Painful shoulder</topic><topic>Physical Examination - methods</topic><topic>Range of Motion, Articular</topic><topic>Sensitivity and Specificity</topic><topic>Shoulder Impingement Syndrome - diagnosis</topic><topic>Shoulder Joint - pathology</topic><topic>Subacromial impingement syndrome</topic><topic>Subacromial–subdeltoid bursitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Silva, L.</creatorcontrib><creatorcontrib>Andréu, J. L.</creatorcontrib><creatorcontrib>Muñoz, P.</creatorcontrib><creatorcontrib>Pastrana, M.</creatorcontrib><creatorcontrib>Millán, I.</creatorcontrib><creatorcontrib>Sanz, J.</creatorcontrib><creatorcontrib>Barbadillo, C.</creatorcontrib><creatorcontrib>Fernández-Castro, M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Silva, L.</au><au>Andréu, J. L.</au><au>Muñoz, P.</au><au>Pastrana, M.</au><au>Millán, I.</au><au>Sanz, J.</au><au>Barbadillo, C.</au><au>Fernández-Castro, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of physical examination in subacromial impingement syndrome</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2008-05-01</date><risdate>2008</risdate><volume>47</volume><issue>5</issue><spage>679</spage><epage>683</epage><pages>679-683</pages><issn>1462-0324</issn><eissn>1462-0332</eissn><coden>BJRHDF</coden><abstract>Objective. Shoulder pain is a common complaint, frequently caused by subacromial impingement syndrome (SIS). There are a number of physical examination (PE) manoeuvres that explore the subacromial space. MRI provides an accurate anatomic image of the subacromial space, being the current gold standard in the diagnosis of SIS. The aim of this study is to evaluate the accuracy of the PE in the diagnosis of SIS and/or subacromial–subdeltoid bursitis (SSB) confirmed by MRI. Methods. Consecutive outpatients with an episode of shoulder pain were prospectively included in the study. They were examined by a rheumatologist and, within 3 days, an MRI was done. Sensitivity, specificity, positive and negative predictive values, and accuracy of PE manoeuvres were calculated using a 2 × 2 table. Results. Fourteen males and 16 females were included. All the tests exhibited acceptable sensitivity. As a result Yocum manoeuvre was considered the most sensitive and most accurate for SIS. With regard to SSB, the Gerber test was the most sensitive. The majority of the PE manoeuvres showed low specificity. Conclusions. Most PE manoeuvres identify reasonably well subacromial impingement of the shoulder, although, in general, they have low specificity. The Yocum test has the best sensitivity and precision. Our data suggest that imaging techniques should be recommended to better define shoulder lesions.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>18375403</pmid><doi>10.1093/rheumatology/ken101</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Clinical evaluation Diseases of the osteoarticular system Female Humans Juxtaarticular diseases. Extraarticular rhumatism Likelihood Functions Magnetic Resonance Imaging Male Medical sciences Middle Aged Miscellaneous. Osteoarticular involvement in other diseases MRI Painful shoulder Physical Examination - methods Range of Motion, Articular Sensitivity and Specificity Shoulder Impingement Syndrome - diagnosis Shoulder Joint - pathology Subacromial impingement syndrome Subacromial–subdeltoid bursitis |
| title | Accuracy of physical examination in subacromial impingement syndrome |
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