Accuracy of the Speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings

Holtby, Richard; Razmjou, Helen

doi:10.1016/j.arthro.2004.01.008

Cited by 208 publications

(128 citation statements)

References 16 publications

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“…[1][2][3]10,13,14 This study demonstrates that by using such a technique, only a mean of 30 to 33 mm (28%-32%) of tendon can be seen, which is at the lower end of previously described technical reports using this technique. 4,8 When these data are further analyzed, it is apparent that the additional excursion with this technique is only 6 mm (lateral decubitus position range, 2-12 mm) and 9 mm (beach-chair position range, 2-14 mm) of the extra-articular portion of the tendon.…”

Section: Discussionmentioning

confidence: 83%

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Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Old

Saithna

Longo

et al. 2017

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 83%

“…9,11,16,22 This also implies that published figures for sensitivities and specificities of common physical examination tests and imaging modalities based on arthroscopy as a gold standard are invalid. [1][2][3]10,13 It would therefore be appropriate for further research to revisit these values based on open exploration to obtain valid data.…”

Section: Discussionmentioning

confidence: 99%

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Old

Saithna

Longo

et al. 2017

Journal of Shoulder and Elbow Surgery

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“…Some authors considered type I lesions as a normal variant and subsequently excluded them as a positive surgical finding. 15,35 Holtby et al 15 did not consider superior labral fraying with an intact biceps tendon and a bucket handle labral tear with an intact biceps as positive surgical findings. These authors therefore reported no data for previously described type III lesions.…”

mentioning

confidence: 99%

“…15 This value is thought to be the chance of having the condition based on the subjective signs and mechanism of injury. This value can then be calculated to produce more accurate predictive values.…”

mentioning

confidence: 99%

“…From the studies reviewed in this paper, the surgeons were blinded to the findings of the clinical tests in only 3 studies. 15,35,36 The QUADAS was used in this review as it has been researched and designed as an evidence-based quality assessment tool. 51 However, the scoring system used, as proposed in a later paper by the developers of the tool, remains controversial.…”

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confidence: 99%

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Diagnostic Accuracy of Clinical Tests for Superior Labral Anterior Posterior Lesions: A Systematic Review

Dessaur

Magarey²

2008

J Orthop Sports Phys Ther

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As surgical procedures have advanced, so has our ability to diagnose and treat such injuries, as we have become more aware of the labral structure and the nature of SLAP injuries. The superior labrum has been found to have a loose attachment to T he surgical management of superior labral anterior posterior (SLAP) lesions of the shoulder has advanced in recent years, as arthroscopic techniques have led to a better understanding of labral anatomy and pathomechanics. With the complicated injuries that may occur at this site, greater emphasis is placed on accurate diagnosis and treatment to return patients to full function.STUDY DESIGN: Systematic literature review. OBJECTIVES:To conduct a systematic review of case series and clinical trials that investigate the diagnostic accuracy of clinical tests for superior labral anterior posterior (SLAP) lesions. BACKGROUND: Primary contact practitionersare often presented with shoulder problems and use a battery of clinical tests to reach a diagnosis. Early detection of SLAP pathology may lead to more optimal interventions and better outcomes for patients. METHODS AND MEASURES:The OVID search interface was utilized with MEDLINE, AHMED, CI-NAHL, and SPORTDiscus databases searched from 1996 to 2006. Studies were retrieved that included patients with shoulder pain who underwent at least 1 clinical shoulder test for SLAP lesions. For an article to be included in this review, the results of the clinical tests needed to be compared with findings on arthroscopy. Quality of the manuscripts included in this review were rated using the QUA-DAS appraisal tool, so comparisons could be made across studies. RESULTS:Seventeen published manuscripts fit the inclusion/exclusion criteria and were used for this review. Eight studies were found to be of high quality. Within these 8 studies, 1 group of authors reported high diagnostic accuracy values for the crank test: sensitivity, 91% (95% confidence interval [CI], 76%-97%); specificity, 93% (95% CI, 79%-98%); positive likelihood ratio, 13.6 (95% CI, 3.6-52.1); and negative likelihood ratio, 0.1 (95% CI, 0.0-0.3). One study on the resisted supination external rotation test also scored high on the QUADAS and reported diagnostic accuracy values of 83% (95% CI, 66-92), 82% (95% CI, 52-95), 4.6 (95% CI, 1.3-16.1), and 0.20 (95% CI, 0.1-0.5), respectively. Of significance is the fact that the majority of papers reporting highly accurate clinical diagnostic tests were of low quality, with the results not supported by other authors.CONCLUSION: It appears that no single test is sensitive or specific enough to determine the presence of a SLAP lesion accurately. Further research is required to determine whether subgrouping of patients by mechanism of injury or the type of SLAP lesion may improve diagnostic accuracy. Determining the diagnostic accuracy of a combination of 2 or more tests is also needed. Ther 2008;38(6):341-352. doi:10.2519/jospt.2008 The vascularity of the labrum is less in the superior and anterosuperior regions compared to the inferior...

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Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement

Hanchard

Lenza

Handoll

et al. 2013

Cochrane Database of Systematic Reviews

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Accuracy of the Speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings

Cited by 208 publications

References 16 publications

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Shoulder arthroscopy does not adequately visualize pathology of the long head of biceps tendon

Diagnostic Accuracy of Clinical Tests for Superior Labral Anterior Posterior Lesions: A Systematic Review

Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement

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