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. 2017 Mar;96(3):176-183.
doi: 10.1097/PHM.0000000000000566.

The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear: The ROW Cohort Study

Nitin B Jain  1 , Jennifer Luz, Laurence D Higgins, Yan Dong, Jon J P Warner, Elizabeth Matzkin, Jeffrey N Katz
Affiliations

The Diagnostic Accuracy of Special Tests for Rotator Cuff Tear: The ROW Cohort Study

Nitin B Jain et al. Am J Phys Med Rehabil. 2017 Mar.

Abstract

Objective: The aim was to assess diagnostic accuracy of 15 shoulder special tests for rotator cuff tears.

Design: From February 2011 to December 2012, 208 participants with shoulder pain were recruited in a cohort study.

Results: Among tests for supraspinatus tears, Jobe test had a sensitivity of 88% (95% confidence interval [CI], 80%-96%), specificity of 62% (95% CI, 53%-71%), and likelihood ratio of 2.30 (95% CI, 1.79-2.95). The full can test had a sensitivity of 70% (95% CI, 59%-82%) and a specificity of 81% (95% CI, 74%-88%). Among tests for infraspinatus tears, external rotation lag signs at 0 degrees had a specificity of 98% (95% CI, 96%-100%) and a likelihood ratio of 6.06 (95% CI, 1.30-28.33), and the Hornblower sign had a specificity of 96% (95% CI, 93%-100%) and likelihood ratio of 4.81 (95% CI, 1.60-14.49).

Conclusions: Jobe test and full can test had high sensitivity and specificity for supraspinatus tears, and Hornblower sign performed well for infraspinatus tears. In general, special tests described for subscapularis tears have high specificity but low sensitivity. These data can be used in clinical practice to diagnose rotator cuff tears and may reduce the reliance on expensive imaging.

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Figures

Figure 1
Figure 1. Eligibility and Exclusion Criteria
Figure 2
Figure 2. Schematic of Patient Population
*Determined by a clinical degree of certainty that patient’s symptoms were attributable to a rotator cuff tear of ≥50 on a 0–100 scale **If patients were clinically determined to not have a rotator cuff tear (degree of certainty<50), they were given a diagnosis of No Rotator Cuff Tear irrespective of imaging findings ┼Due to time constraints in clinic
See this image and copyright information in PMC

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