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Diagnosing patients with longstanding shoulder joint pain
J Nørregaard1, M R Krogsgaard, T Lorenzen
1Department of Rheumatology, Copenhagen University Hospital, Bispebjerg, Denmark. j.norregaard@dadlnet.dk
Annals of the Rheumatic Diseases
|June 25, 2002
Summary
Clinical shoulder tests and diagnoses show poor agreement and low accuracy for shoulder pain. Ultrasonography is accurate for full thickness supraspinatus tears but not partial tears or labral lesions, compared to arthroscopy.
Area of Science:
- Orthopedic Surgery
- Diagnostic Imaging
Background:
- Shoulder pain is a common complaint.
- Accurate diagnosis is crucial for effective treatment.
Purpose of the Study:
- To evaluate the interobserver agreement of clinical shoulder tests.
- To assess the accuracy of clinical tests and ultrasonography against arthroscopic findings.
Main Methods:
- Eighty-six patients with shoulder pain underwent clinical examination by two doctors.
- Ultrasonography was performed on all patients; arthroscopy on 42.
- Examinations were blinded.
Main Results:
- Clinical tests for impingement, muscle tenderness, weakness, and labral lesions showed poor to moderate agreement.
- Clinical diagnoses had poor agreement and low accuracy.
- Ultrasonography accurately identified full thickness supraspinatus tears but not partial tears or labral lesions.
Conclusions:
- Most clinical shoulder tests exhibit poor interobserver agreement.
- Clinical and ultrasonographic diagnoses demonstrate low accuracy when compared to arthroscopy.