Validity of the supraspinatus test as a single clinical test in diagnosing patients with rotator cuff pathology

Abstract

Study design: Prospective blinded comparison of clinical examination and surgical findings of consecutive patients seen at a tertiary shoulder center.

Objective: To investigate the validity of the supraspinatus test in diagnosing rotator cuff pathology using arthroscopy or open surgery as reference standards. A positive supraspinatus test was defined as pain for all types of rotator cuff pathology and weakness for full-thickness tears.

Background: Rotator cuff tenopathy is a very common condition. However, there have been relatively few studies documenting the validity of physical examination for this condition and further investigation of the measurement properties of these tests is warranted.

Methods and measures: One hundred two consecutive subjects were examined. Fifty subjects, ranging in age between 24 and 79 years (mean age, 50 years; SD, 14.4 years) and composed of 16 females and 34 males, underwent surgery.

Results: The sensitivity of the supraspinatus test was 62%, 41%, and 88% for "supraspinatus tendonitis or partial thickness tear," "full-thickness tear," and "large to massive tears," respectively. The specificity values were 54%, 70%, and 70% for the above conditions, respectively. The negative likelihood ratios varied from 0.17 to 0.84, and the positive likelihood ratios varied from 1.35 to 2.93, depending on the presence of pain or weakness.

Conclusion: Application of the supraspinatus test in isolation is helpful in diagnosing large or massive rotator cuff tears. The change that this test makes in pretest probability of less extensive rotator cuff pathology is insignificant.