Diagnostic performance of clinical tests for subscapularis tendon tears

Kappe, Thomas; Sgroi, Mirco; Reichel, Heiko; Daexle, Manuel

doi:10.1007/s00167-017-4617-4

Cited by 22 publications

(21 citation statements)

References 38 publications

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“…The belly-off test is in 2 studies ,53,55 total 156 patients and its diagnostic utility values are ranging from 31-86%, 91-97% and 9.6-10.3 correspondingly, whereas the IRLS was investigated in both surgical and indirect imaging reference standards. In surgical reference standard, IRLS was in 4 studies 52,53,54,55 total 703 patients and its diagnostic utility values sensitivity, specificity and +LR range from 31.6-71%, 60-92.5% and 1.8-4.6 respectively in contrast in indirect imaging criterion standard, IRLS was in one study 48 total 104 patients its utility ranged from 31%, 87% and 2.4.…”

Section: Clinical Tests For Subscapularismentioning

confidence: 99%

“…However, except IRLS, other 4 clinical tests were investigated only against the surgical reference standard. The lift-off is in 6 studies 49,50,51,52,53,54 total 934 painful shoulders. The diagnostic utility values ranged from 18.8-65.2%, 68.5-98% and 1.9-17.5 respectively.…”

Section: Clinical Tests For Subscapularismentioning

confidence: 99%

“…The diagnostic utility values ranged from 18.8-65.2%, 68.5-98% and 1.9-17.5 respectively. The belly-press test is in 5 studies 49,51,52,53,54 total 833 patients and diagnostic utility values range are in the following way 34-80%, 79.7-96% and 3.2-8.5. The bear hug test is in 4 studies ,52,53,54 total 783 patients.…”

Section: Clinical Tests For Subscapularismentioning

confidence: 99%

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Diagnostic accuracy of clinical tests to diagnose subacromial impingement syndrome: A systematic review

S.Thiruvarangan¹,

T.Shaminy²

2021

IJRP

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The aim of this review was to systematically review the cost-effective diagnostic utility of clinical tests to diagnose subacromial impingement syndrome. Data SourcesThe following electronic databases: Medline, EMBASE, Science Direct and the Cochrane Library were searched in June 2020 to identify the studies that investigated the diagnostic accuracy of clinical tests to diagnose SAIS. The search was restricted to articles written in English. Study SelectionThis study included diagnostic accuracy of cohort studies that directly compared the diagnostic utility of clinical tests for diagnosing SAIS against either surgical or indirect imaging reference standards. The PRISMA guidelines were followed to accomplish this review. Two reviewers independently performed the study's methodological quality assessment by using the QUADAS tool. Data ExtractionThe sensitivity and specificity for each clinical test waa extracted from the included studies and both positive and negative likelihood ratios were tabulated either direct from available studies or calculated from the provided sensitivity and specificity data. Data SynthesisThis review included 14 studies in total of 1756 shoulders and considered standard, modified and novel clinical tests for making a differential diagnosis on SAIS. In this review, included studies' overall methodological quality is high and there appears to be the diagnostic utility of the subacromial grinding test, lift-off, bear-hug and belly-off tests provide significant evidence to rule in SAIS when the tests are positive. ConclusionThis is an updated study of a previous systematic review on the diagnostic accuracy of clinical tests for SAIS. Making a precise differential diagnosis will ultimately ensure the appropriate therapeutic interventions, subsequently successful prognosis on SAIS patients thus, this review findings of diagnostic utility clinical tests need to be considered in the context of clinical practice of the overall patient assessment.

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Section: Clinical Tests For Subscapularismentioning

confidence: 99%

Section: Clinical Tests For Subscapularismentioning

confidence: 99%

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Diagnostic accuracy of clinical tests to diagnose subacromial impingement syndrome: A systematic review

S.Thiruvarangan¹,

T.Shaminy²

2021

IJRP

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“…Barth 4 Bartsch 5 Itoi 19 Kappe 21 Kim 22 Lasbleiz 23 Lin 25 Miller 30 Salaffi 34 Somerville 36 Takeda 37 van Kampen 38 Yoon 39 Patient selection 2). The reference diagnostic method was arthroscopy in 6 studies and MRI or MRA in 2 studies.…”

Section: Domainmentioning

confidence: 99%

Diagnostic Accuracy of Clinical Tests for Subscapularis Tears: A Systematic Review and Meta-analysis

Lädermann

Zbinden

Meynard

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Previous systematic reviews and meta-analyses on the diagnostic accuracy of shoulder clinical tests do not reach conclusions regarding subscapularis tears. Purpose: To compare the diagnostic accuracy of commonly used clinical tests for subscapularis tears. Study Design: Systematic review; Level of evidence, 3. Methods: An electronic literature search was conducted using Medline, Embase, and the Cochrane Library/Central. Eligibility criteria were original clinical studies reporting the diagnostic accuracy of clinical tests to diagnose the presence of rotator cuff tears involving the subscapularis. Results: The electronic literature search returned 2212 records, of which 13 articles were eligible. Among 8 tests included in the systematic review, the lift-off test was most frequently reported (12 studies). Four tests were eligible for meta-analysis: bear-hug test, belly-press test, internal rotation lag sign (IRLS), and lift-off test. The highest pooled sensitivity was 0.55 (95% CI, 0.28-0.79) for the bear-hug test, while the lowest pooled sensitivity was 0.32 (95% CI, 0.13-0.61), for the IRLS. In all tests, pooled specificity was >0.90. Conclusion: Among the 4 clinical tests eligible for meta-analysis (bear-hug test, belly-press test, IRLS, and lift-off test), all had pooled specificity >0.90 but pooled sensitivity <0.60. No single clinical test is sufficiently reliable to diagnose subscapularis tears. Registration: PROSPERO (CRD42019137019).

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“… 11 Clinical exam may reveal increased range of motion on passive external rotation, weakness on internal rotation, and a positive belly-press test or lift-off test. 12 …”

Section: Techniquementioning

confidence: 99%

Arthroscopic Repair of an Isolated Subscapularis Tendon Rupture in an Adolescent Patient

Agarwalla

Puzzitiello

Leong

et al. 2018

Arthroscopy Techniques

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Arthroscopic repair of an isolated subscapularis tendon rupture has been previously described in the adult population; however, the technique has yet to be described in a pediatric patient. In this Technical Note, we describe an arthroscopic repair of an isolated subscapularis tendon rupture with concomitant mini-open suprapectoral biceps tenodesis in an adolescent patient. Standard anterior and posterior portals are established with an accessory portal in the anterosuperior angle of the acromion. A 0-PDS suture is used to pass strands of suture tape through the inferolateral and superolateral aspects of the subscapularis tendon. Suture tape is passed through a suture anchor and the accessory portal and is fixated at the junction of the inferior one-third and superior two-thirds of the subscapularis tendon footprint and at the junction of the superior one-third and inferior two-thirds of the subscapularis tendon footprint. Following subscapularis tendon fixation, biceps tenodesis is performed through either a mini-open subpectoral or arthroscopic suprapectoral approach. This described technique allows for full visualization of the subscapularis tendon and lesser tuberosity. Additionally, this technique allows for accurate placement of suture anchors to maximize footprint coverage and appropriate graft tensioning.

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Diagnostic performance of clinical tests for subscapularis tendon tears

Abstract: Diagnostic study, Level I.

Cited by 22 publications

References 38 publications

Diagnostic accuracy of clinical tests to diagnose subacromial impingement syndrome: A systematic review

Diagnostic accuracy of clinical tests to diagnose subacromial impingement syndrome: A systematic review

Diagnostic Accuracy of Clinical Tests for Subscapularis Tears: A Systematic Review and Meta-analysis

Arthroscopic Repair of an Isolated Subscapularis Tendon Rupture in an Adolescent Patient

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