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2015 ; 15
(60
): 29-44
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Correlation of findings in clinical and high resolution ultrasonography
examinations of the painful shoulder
#MMPMID26674725
Micheroli R
; Kyburz D
; Ciurea A
; Dubs B
; Toniolo M
; Bisig SP
; Tamborrini G
J Ultrason
2015[Mar]; 15
(60
): 29-44
PMID26674725
show ga
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 findings 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 specificity (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 specificity (0.72). The
infraspinatus test showed a high sensitivity (0.90) and specificity (0.74). All
AC tests (painful arc II(a), AC joint tenderness(b), cross body adduction stress
test(c)) showed high specificities ((a)0.96, (b)0.99, (c)0.96). Evaluating the
long biceps tendon, the palm up test showed the highest sensitivity (0.47) and
the Yergason test the highest specificity (0.88). CONCLUSION: Knowledge of
sensitivity and specificity 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.