[Value of standard radiographies in the diagnosis of rotator cuff rupture]

To assess the value of the Leclercq maneuver (anteroposterior roentgenogram of the shoulder during resisted active abduction) for the diagnosis of rotator cuff tear, the medical records of 93 patients evaluated by glenohumeral arthrography, standard radiographs, and radiographs taken using the Leclercq maneuver were retrospectively reviewed. The comparison of patients with (n = 53) and without (n = 40) arthrographic evidence of rotator cuff tear demonstrated statistically significant differences for mean acromiohumeral space difference between the normal and affected shoulders, for the acromiohumeral space difference between the standard film and Leclercq maneuver film, and for presence of an inferior glenohumeral diastasis on the Leclercq maneuver film. An acromiohumeral space of 7 mm or less on standard radiographs proved a specific (0.975) but insensitive (0.24) sign of rotator cuff tear. This parameter measured on the Leclercq maneuver film exhibited better sensitivity (0.62) and excellent specificity. Other criteria with good specificity for rotator cuff tear included an acromiohumeral space difference between the normal and abnormal side of 2 mm or more (0.97), an acromiohumeral space difference between standard and Leclercq maneuver films of at least 4 mm, and existence of an inferior glenohumeral diastasis; however, sensitivities of these three parameters were poor (respectively 0.65; 0.20; and 0.19).(ABSTRACT TRUNCATED AT 250 WORDS)