Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(03): 467-471
DOI: 10.1055/s-0041-1735945
Artigo Original

Correlation of Physical Examination with Arthroscopic Findings in the Treatment of Rotator Cuff Tear

Article in several languages: português | English
Flávio de Oliveira França 
1   Serviço de Cirurgia do Ombro e Cotovelo, Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
,
Glaydson Gomes Godinho 
1   Serviço de Cirurgia do Ombro e Cotovelo, Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
,
José Márcio Alves Freitas 
1   Serviço de Cirurgia do Ombro e Cotovelo, Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
,
Augusto Silveira Lang 
2   Especializando em Cirurgia do Ombro e Cotovelo do Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
,
Charles Diogo Ammar 
2   Especializando em Cirurgia do Ombro e Cotovelo do Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
,
Fabrício Martinelli 
2   Especializando em Cirurgia do Ombro e Cotovelo do Hospital Ortopédico BH, Belo Horizonte, MG, Brasil
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective To compare clinical data from the physical examination with arthroscopic findings in rotator cuff rupture.

Methods A total of 177 patients submitted to arthroscopic treatment of rotator cuff rupture were selected, and arthroscopic findings were compared with physical examination.

Results The impingement tests showed high sensitivity for rotator cuff rupture. Among the strength tests, the most sensitive was the Patte test (85.7%), and the one with the highest positive predictive value (PPV) was the Jobe test (95%). The Drop Sign test showed higher specificity and negative predictive value (NPV) (98.7 and 95.9%, respectively). Patients with a history of trauma were 3.5 times more likely to have a positive Lift Off test.

Conclusion The impingement tests had high sensitivity for rotator cuff ruptures. The Jobe test showed similar sensitivity among patients who had partial or total supraspinal injury. For complete lesions of the subscapularis, The Lift Off and Belly Press tests showed high sensitivity and specificity.

Keywords

arthroscopy - physical examination - rotator cuff - shoulder - rupture

Financial Support

There was no financial support from public, commercial, or nonprofit sources.


Study carried out by the Shoulder Surgery and Rehabilitation Group of Hospital Ortopédico, Belo Horizonte, MG, Brazil.




Publication History

Received: 05 July 2020

Accepted: 02 June 2021

Article published online:
30 June 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Neer 2nd. CS. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972; 54 (01) 41-50
    Search in Google Scholar
  • 2 Malhi AM, Khan R. Correlation between clinical diagnosis and arthroscopic findings of the shoulder. Postgrad Med J 2005; 81 (960) 657-659
    CrossrefPubMedSearch in Google Scholar
  • 3 Pompan DC. Appropriate use of MRI for evaluating common musculoskeletal conditions. Am Fam Physician 2011; 83 (08) 883-884
    PubMedSearch in Google Scholar
  • 4 Jobe FW, Jobe CM. Painful athletic injuries of the shoulder. Clin Orthop Relat Res 1983; (173) 117-124
    PubMedSearch in Google Scholar
  • 5 Gerber C, Krushell RJ. Isolated rupture of the tendon of the subscapularis muscle. Clinical features in 16 cases. J Bone Joint Surg Br 1991; 73 (03) 389-394
    CrossrefPubMedSearch in Google Scholar
  • 6 Hertel R, Ballmer FT, Lombert SM, Gerber C. Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elbow Surg 1996; 5 (04) 307-313
    CrossrefPubMedSearch in Google Scholar
  • 7 Walch G, Boulahia A, Calderone S, Robinson AH. The ‘dropping’ and ‘hornblower's’ signs in evaluation of rotator-cuff tears. J Bone Joint Surg Br 1998; 80 (04) 624-628
    CrossrefPubMedSearch in Google Scholar
  • 8 Gerber C, Hersche O, Farron A. Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 1996; 78 (07) 1015-1023
    CrossrefPubMedSearch in Google Scholar
  • 9 Debeyre J, Elmelik E, Patte D. [Shoulder injuries and ruptures of the musculo-tendinous cuff]. Presse Med 1963; 71: 1521-1522
    Search in Google Scholar
  • 10 Neer 2nd. CS. Impingement lesions. Clin Orthop Relat Res 1983; (173) 70-77
    PubMedSearch in Google Scholar
  • 11 Hawkins RJ, Kennedy JC. Impingement syndrome in athletes. Am J Sports Med 1980; 8 (03) 151-158
    CrossrefPubMedSearch in Google Scholar
  • 12 Yocum LA. Assessing the shoulder. History, physical examination, differential diagnosis, and special tests used. Clin Sports Med 1983; 2 (02) 281-289
    PubMedSearch in Google Scholar
  • 13 Yergason RM. Supination sing. J Bone Joint Surg Am 1931; 13 (01) 160-161
    Search in Google Scholar
  • 14 Bennett WF. Specificity of the Speed's test: arthroscopic technique for evaluating the biceps tendon at the level of the bicipital groove. Arthroscopy 1998; 14 (08) 789-796
    Search in Google Scholar
  • 15 Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal?. J Bone Joint Surg Am 2005; 87 (06) 1229-1240
    Search in Google Scholar
  • 16 Lafosse L, Jost B, Reiland Y, Audebert S, Toussaint B, Gobezie R. Structural integrity and clinical outcomes after arthroscopic repair of isolated subscapularis tears. J Bone Joint Surg Am 2007; 89 (06) 1184-1193
    CrossrefPubMedSearch in Google Scholar
  • 17 Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 1990; (254) 64-74
    PubMedSearch in Google Scholar
  • 18 MacDonald PB, Clark P, Sutherland K. An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial impingement signs. J Shoulder Elbow Surg 2000; 9 (04) 299-301
    CrossrefPubMedSearch in Google Scholar
  • 19 Nicoletti SJ, Albertoni WM. Valor do exame físico no diagnóstico do pinçamento subacromial e das lesões do manguito rotador. Rev Bras Ortop 1993; 28 (09) 679-682
    Search in Google Scholar
  • 20 Leroux JL, Thomas E, Bonnel F, Blotman F. Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum Engl Ed 1995; 62 (06) 423-428
    PubMedSearch in Google Scholar
  • 21 Fowler EM, Horsley IG, Rolf CG. Clinical and arthroscopic findings in recreationally active patients. Sports Med Arthrosc Rehabil Ther Technol 2010; 2: 2
    PubMedSearch in Google Scholar
  • 22 Bartsch M, Greiner S, Haas NP, Scheibel M. Diagnostic values of clinical tests for subscapularis lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18 (12) 1712-1717
    CrossrefPubMedSearch in Google Scholar
  • 23 Schiefer M, Ching-San Júnior YA, Silva SM. et al. Clinical diagnosis of subscapularis tendon tear using the Bear Hug semiological maneuver. Rev Bras Ortop 2012; 47 (05) 588-592
    Search in Google Scholar
  • 24 Cardoso A, Amaro P, Barbosa L, Coelho AM, Alonso R, Pires L. Diagnostic accuracy of clinical tests directed to the long head of biceps tendon in a surgical population: a combination of old and new tests. J Shoulder Elbow Surg 2019; 28 (12) 2272-2278
    CrossrefPubMedSearch in Google Scholar