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a, Kenan Akgüna, Murat Birtaneb, Ilhan Karacanc, Havva Çala, Fikret Tüzüna
a Department of
Physical Medicine and Rehabilitation, Cerrahpasa Faculty of Medicine
Istanbul, Turkey, b Department of
Physical Medicine and Rehabilitation, Trakya University, Faculty of
Medicine, Edirne, Turkey, c Aksaray Vatan Hospital, Istanbul, Turkey
Correspondence to: Dr M Birtane, Kocasinan Mah 6 Sok, Akan 3 Apt no 3, Daire 4, Edirne, Turkey
Accepted for publication 10 August 1999
OBJECTIVE
Subacromial
impingement syndrome (SIS) is a frequent cause of shoulder pain. The
aim of this study was to investigate the diagnostic values of clinical
diagnostic tests, in patients with SIS.
METHODS72 female, 48 male patients with shoulder pain were included in the study. Five had
bilateral shoulder pain, so 125 painful shoulders were evaluated.
Details were recorded about the patients' ages and sexes, as well as
characteristics of pain and related problems. Detailed physical
examination and routine laboratory tests were performed. Conventional
radiography and subsequent magnetic resonance imaging of the shoulder
region of all patients were performed. Patients were divided into two
groups according to the results of subacromial injection test, a
reference standard test for SIS. Test positive patients constituted SIS
group and test negative patients the non-SIS group. Sensitivity,
specificity, accuracy, positive and negative predictive values of some
clinical diagnostic tests such as Neer, Hawkins, horizontal adduction, painful arc, drop arm, Yergason and Speed tests for SIS were determined by using 2 × 2 table.
RESULTSThe most
sensitive diagnostic tests were found to be Hawkins test (92.1%), Neer
test (88.7%) and horizontal adduction test (82.0%). Tests with
highest specificity were drop arm test (97.2%), Yergason test (86.1%)
and painful arc test (80.5%) consecutively.
CONCLUSIONThe highly
sensitive tests seem to have low specificity values and the highly
specific ones to have low sensitivity values. Although this finding
suggests that these diagnostic tests are insufficient for certain
diagnosis, it is suggested they play an important part in clinical evaluation.
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