Reliable diagnosis of posterosuperior rotator cuff tears requires a combination of clinical tests.
Clinical tests
Diagnostic accuracy
Infraspinatus
Meta-analysis
Posterosuperior
Rotator cuff tear
Supraspinatus
Teres minor
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
25
03
2020
accepted:
26
06
2020
pubmed:
30
7
2020
medline:
14
7
2021
entrez:
30
7
2020
Statut:
ppublish
Résumé
Clinical diagnosis of posterosuperior rotator cuff tears remains uncertain due to a lack of evidence-based consensus. This review aimed to compare the diagnostic accuracy of commonly used clinical tests for posterosuperior rotator cuff tears. The authors conducted an electronic literature search using Medline, Embase and the Cochrane library/Central, to identify original clinical studies reporting diagnostic accuracy of clinical tests to diagnose the presence of posterosuperior rotator cuff tears involving the infraspinatus, supraspinatus and/or teres minor. The electronic literature search returned 1981 records, of which 14 articles were eligible. Among 17 tests included in the systematic review, 6 tests were eligible for meta-analysis: drop arm sign, Jobe test, external rotation lag sign, Hawkins-Kennedy test, Neer test and painful arc abduction test. According to QUADAS-2 criteria, risk of bias was low in 1 study, moderate in 2 and high in 4. The highest pooled sensitivity was 0.77 (CI 0.67-0.85), for the Jobe test, while the lowest pooled sensitivity was 0.38 (CI 0.01-0.98), for the drop arm sign. The Jobe test had the best pooled sensitivity, while the drop arm sign had the best pooled specificity. As no single clinical test is sufficiently reliable to diagnose posterosuperior rotator cuff tears, clinicians should consider various combinations of patient characteristics and clinical tests, as well as imaging modalities, to confirm diagnosis and select the appropriate treatment option. More reliable clinical diagnosis of posterosuperior rotator cuff tears could reduce the reliance on magnetic resonance imaging or arthrography and their associated costs and waiting times. Level II.
Identifiants
pubmed: 32725446
doi: 10.1007/s00167-020-06136-9
pii: 10.1007/s00167-020-06136-9
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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