Comparing shoulder maneuvers to magnetic resonance imaging and arthroscopic findings in patients with supraspinatus tears  

作　　者：Fabio Anauate Nicolao Joao Alberto Yazigi Junior Fabio Teruo Matsunaga Nicola Archetti Netto Joao Carlos Belloti Marcel Jun Sugawara Tamaoki 

机构地区：[1]Orthopedics and Traumatology Department,Escola Paulista de Medicina–Universidade Federal de São Paulo–UNIFESP,Sao Paulo 04038-001,Brazil [2]Orthopedics and Traumatology Discipline,Universidade de Santo Amaro–UNISA,Sao Paulo 04829-300,Brazil

出　　处：《World Journal of Orthopedics》2022年第1期102-111,共10页世界骨科杂志（英文版）

摘　　要：BACKGROUND Shoulder maneuvers and magnetic resonance imaging(MRI)are performed to diagnose supraspinatus tendon tears regardless of arthroscopy exam.Although there are many studies on this subject,there is a lack of studies comparing the sensitivity(Se)and specificity(Sp)of shoulder maneuvers and MRI to arthroscopic findings(intact,partial,or full thickness supraspinatus tendon tear).AIM To compare the diagnostic values of shoulder maneuvers with MRI for supraspinatus tendon tears in patients undergoing shoulder arthroscopy.METHODS A total of 199 consecutive patients from four orthopedic centers met the eligibility criteria of shoulder pain persisting for at least four weeks.They were prospectively enrolled in this study from April 2017 to April 2019.Seven clinical tests(full can,empty can,drop arm,Hawkins’,painful arc,Neer’s sign and resisted external rotation)and MRI were performed,and all were compared with surgical findings.Full can,empty can and resisted external rotation tests were interpreted as positive in the case of pain and/or weakness.We assessed the Se,Sp,accuracy,positive predictive value(PPV)and negative predictive value(NPV),positive and negative likelihood ratio and diagnostic odds ratio for overall,partial and fullthickness supraspinatus tears.RESULTS MRI had the highest Se for overall(0.97),partial(0.91)and full-thickness(0.99)tears;moreover,MRI had the highest NPV:0.90,0.88 and 0.98 for overall,partial and full-thickness tears,respectively.For overall supraspinatus tears,the Se and PPV were:Painful arc(Se=0.85/PPV=0.91),empty can(pain)(Se=0.80/PPV=0.89),full can(pain)(Se=0.78/PPV=0.90),resisted external rotation(pain)(Se=0.48/PPV=0.87),drop arm(Se=0.19/PPV=0.97),Neer’s sign(Se=0.78/PPV=0.93)and Hawkins’(Se=0.80/PPV=0.88).MRI had the highest PPV(0.99).The Hawkin’s test had the highest false positive rate in patients with intact tendons(0.36).The Sp of the empty can and full can(both tests positive for pain and weakness),drop arm and MRI were:0.93,0.91,0.98 and 0.96,respectively.For pa

关 键 词：Rotator cuff injuries Physical examination Magnetic resonance imaging ARTHROSCOPY 

分 类 号：R685[医药卫生—骨科学]