Diagnosis of rotator cuff tears

Currently, imaging techniques such as MRI, musculoskeletal ultrasound and even arthroscopy are widely used in the diagnosis of rotator cuff tears, mostly due to a lack of evidence regarding the predictive value of patient characteristics, history-taking and clinical examination.

In this study, 100 new patients with shoulder pain and no history of shoulder instability completed two questionnaires (the Simple Shoulder Test and the Oxford Shoulder Score), underwent nine clinical examination tests (the Jobe, Neer, Hawkins-Kennedy, Drop Arm, Lift-off, Painful arc and Infraspinatus strength tests, the External rotation lag sign and the Drop sign) and magnetic resonance arthrography to investigate the diagnostic value of the tests and to establish a model for diagnosing rotator cuff tears.

Although some tests had a high specificity, individual clinical examination tests only had a moderate diagnostic value. The only two predictive factors that remained in the prediction model were age and the Neer test – the predictive value of this model was relatively low, and thus, the use of imaging and/ or invasive techniques to confirm the diagnosis of a rotator cuff tear is still recommended.

> From: Van Kampen et al., J Orthop Surg Res 9 (2014) 70. All rights reserved to The Author(s). Click here for the Pubmed summary.