The internal rotation and shift-test for the detection of superior lesions of the rotator cuff: reliability and clinical performance.
Clinical test
Orthopedic exam
Reliability
Rotator cuff
Shoulder
Validity
Journal
JSES international
ISSN: 2666-6383
Titre abrégé: JSES Int
Pays: United States
ID NLM: 101763461
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
entrez:
16
5
2022
pubmed:
17
5
2022
medline:
17
5
2022
Statut:
epublish
Résumé
Using reliable and valid clinical tests are essential for proper diagnosis and clinical outcomes among injuries involving the rotator cuff. The addition of a new clinical examination test could improve the clinical diagnosis and informative value of the sensitivity and specificity of pathology. This study of diagnostic accuracy evaluated the use of a new rotator cuff test, called the internal rotation and shift-test (IRO/shift-test), to determine its reliability and clinical performance (sensitivity, specificity, positive (PPV)/negative predictive value (NPV)). Clinical diagnostic outcomes were confirmed with radiological findings (MRI). 100 patients from a specialized shoulder unit participated (64 male, 36 female, mean age: 55 ± 13.5 years). A single-blinded (no knowledge of prior clinical or technical diagnostics) study design was used with two experienced physicians performing the IRO/shift-test. For clinical performance, all clinical testing was compared with MRI. The intra-rater (ICC = 0.73, 95% CI: 60-82) and inter-rater (ICC = 0.89, 95% CI: 81-94) coefficients for the IRO/shift-test showed good-to-excellent reliability. 75% of the patients showed a positive IRO/shift-test, while 65% had a radiologically diagnosed superior rotator cuff tear. 60% of these patients had both a positive IRO/shift-test and objective rotator cuff tear via MRI. The sensitivity of the IRO/shift-test to detect superior rotator cuff lesions based on MRI diagnosis was calculated at 92% (95% CI: 86-99%), while specificity was 67% (95% CI: 50-84%). Predictive values were also found to be high with 86% PPV (95% CI: 78-94%) and 80% NPV (95% CI: 64-96%). Our results demonstrate that the IRO/shift-test is a reliable and valid tool for assessing superior rotator cuff pathology. With good-to-excellent intrarater and inter-rater reliability and strong sensitivity and specificity this test should be considered a valuable addition to clinicians' cadre of clinical evaluation tools.
Sections du résumé
Background
UNASSIGNED
Using reliable and valid clinical tests are essential for proper diagnosis and clinical outcomes among injuries involving the rotator cuff. The addition of a new clinical examination test could improve the clinical diagnosis and informative value of the sensitivity and specificity of pathology. This study of diagnostic accuracy evaluated the use of a new rotator cuff test, called the internal rotation and shift-test (IRO/shift-test), to determine its reliability and clinical performance (sensitivity, specificity, positive (PPV)/negative predictive value (NPV)). Clinical diagnostic outcomes were confirmed with radiological findings (MRI).
Methods
UNASSIGNED
100 patients from a specialized shoulder unit participated (64 male, 36 female, mean age: 55 ± 13.5 years). A single-blinded (no knowledge of prior clinical or technical diagnostics) study design was used with two experienced physicians performing the IRO/shift-test. For clinical performance, all clinical testing was compared with MRI.
Results
UNASSIGNED
The intra-rater (ICC = 0.73, 95% CI: 60-82) and inter-rater (ICC = 0.89, 95% CI: 81-94) coefficients for the IRO/shift-test showed good-to-excellent reliability. 75% of the patients showed a positive IRO/shift-test, while 65% had a radiologically diagnosed superior rotator cuff tear. 60% of these patients had both a positive IRO/shift-test and objective rotator cuff tear via MRI. The sensitivity of the IRO/shift-test to detect superior rotator cuff lesions based on MRI diagnosis was calculated at 92% (95% CI: 86-99%), while specificity was 67% (95% CI: 50-84%). Predictive values were also found to be high with 86% PPV (95% CI: 78-94%) and 80% NPV (95% CI: 64-96%).
Conclusion
UNASSIGNED
Our results demonstrate that the IRO/shift-test is a reliable and valid tool for assessing superior rotator cuff pathology. With good-to-excellent intrarater and inter-rater reliability and strong sensitivity and specificity this test should be considered a valuable addition to clinicians' cadre of clinical evaluation tools.
Identifiants
pubmed: 35572448
doi: 10.1016/j.jseint.2022.01.011
pii: S2666-6383(22)00059-7
pmc: PMC9091795
doi:
Types de publication
Journal Article
Langues
eng
Pagination
495-499Informations de copyright
© 2022 The Authors.
Références
Br J Sports Med. 2008 Feb;42(2):80-92; discussion 92
pubmed: 17720798
Joints. 2014 Jul 08;2(2):54-8
pubmed: 25606543
Arthroscopy. 2018 Aug;34(8):2326-2333
pubmed: 29802066
Arch Orthop Trauma Surg. 2015 Dec;135(12):1719-26
pubmed: 26386839
Dtsch Arztebl Int. 2021 Aug 23;118(33-34):555-560
pubmed: 34725029
J Orthop Sports Phys Ther. 2020 May;50(5):222-225
pubmed: 32272031
Arthroscopy. 2010 Feb;26(2):249-55
pubmed: 20141988
J Man Manip Ther. 2010 Mar;18(1):3-4
pubmed: 21655416
J Bone Joint Surg Am. 2013 Nov 20;95(22):1993-2000
pubmed: 24257656
Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2081-2088
pubmed: 27872991
PLoS One. 2016 Dec 9;11(12):e0167738
pubmed: 27936246
J Bone Joint Surg Am. 1995 Jan;77(1):10-5
pubmed: 7822341
Lancet. 2003 Oct 4;362(9390):1100-5
pubmed: 14550696
Am J Phys Med Rehabil. 2016 Mar;95(3):161-8
pubmed: 26829075
J Fam Pract. 2002 Jul;51(7):605-11
pubmed: 12160496
Sports Med. 2000 Jul;30(1):1-15
pubmed: 10907753
Am J Sports Med. 2014 Aug;42(8):1911-9
pubmed: 24936584
CMAJ. 1995 May 15;152(10):1595-8
pubmed: 7743445
Arthritis Rheum. 2006 Oct 15;55(5):765-78
pubmed: 17013824
J Shoulder Elbow Surg. 2019 Sep;28(9):1699-1706
pubmed: 31279721
Am J Phys Med Rehabil. 2017 Mar;96(3):176-183
pubmed: 27386812
J Shoulder Elbow Surg. 2021 Aug;30(8):1834-1843
pubmed: 33675978
BMC Musculoskelet Disord. 2017 Jan 25;18(1):41
pubmed: 28122541
Psychol Bull. 1979 Mar;86(2):420-8
pubmed: 18839484
Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2616-2623
pubmed: 33649936
Arch Orthop Trauma Surg. 2015 Dec;135(12):1691-700
pubmed: 26296802
Arch Phys Med Rehabil. 2014 Dec;95(12):2444-69
pubmed: 24909587
Joint Bone Spine. 2009 Jan;76(1):15-9
pubmed: 19059801
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2118-2133
pubmed: 32725446
Am J Med. 2007 Apr;120(4):374-8
pubmed: 17398236
J Clin Orthop Trauma. 2021 Jul 21;21:101514
pubmed: 34367915