Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

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Journal of Ultrasonography

Polish Ultrasound Society (Polskie Towarzystwo Ultrasonograficzne)

Subject: Medicine

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ISSN: 2084-8404
eISSN: 2451-070X

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VOLUME 15 , ISSUE 60 (March 2015) > List of articles

Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

Raphael Micheroli * / Diego Kyburz / Adrian Ciurea / Beat Dubs / Martin Toniolo / Samuel Pascal Bisig / Giorgio Tamborrini

Keywords : ultrasonography, physical examination,  shoulder, pain,  diagnosis

Citation Information : Journal of Ultrasonography. Volume 15, Issue 60, Pages 29-44, DOI: https://doi.org/10.15557/JoU.2015.0003

License : (CC BY-NC-ND 4.0)

Received Date : 07-September-2014 / Accepted: 05-December-2014 / Published Online: 13-September-2016

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ABSTRACT

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, c0.96). 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. 

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