Healio.com
Somerville LE.
Am J Sports Med. 2014. doi:10.1177/0363546514538390.
August 13, 2014
Study data have shown no one test can accurately diagnose rotator cuff tears or tendinosis.
Researchers reviewed 139 consecutive patients being examined at two orthopedic clinics for possible rotator cuff lesions. If a diagnosis was uncertain after taking patients’ medical history, a clinician performed physical examinations to diagnose possible lesions.
Arthroscopy and MRI with arthrogram were the reference standards for patients with and without surgery, respectively. Sensitivity, specificity and likelihood ratios were determined to ascertain whether multiple combinations of frequently used tests offered stronger predictions of accurate diagnosis.
Separately, none of the tests were highly sensitive in the diagnosis of rotator cuff tears or tendinosis, according to the researchers.
Additionally, although no combination of tests improved diagnosis sensitivity and specificity, if there was at least one positive test for tendinosis, sensitivity for detecting full-thickness tears was 88.5%.
Internal rotation and lateral rotation lag sign did not improve the likelihood of an accurate diagnosis of subscapularis or supraspinatus tears; however, lateral rotation lag sign was found to demonstrate a discriminatory ability for tear size.
The ideal cutoff for accurately diagnosing a supraspinatus tear was found to be 2.9 cm with a sensitivity of 80% and a specificity of 81.4%, according to the researchers. Subscapularis tests were unable to differentiate tear sizes.
Disclosure: This study received funding through an internal source that paid for research assistant time to collect data.