Painful Jerk Test: A Predictor of Success in Nonoperative Treatment of Posteroinferior Instability of the Shoulder

Kim, Seung‐Ho; Jeong, Woong Kyo; Park, Jae-Chul; Park, Jun-Sic; Oh, Irvin

doi:10.5397/cise.2004.7.2.057

Cited by 24 publications

(34 citation statements)

References 7 publications

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“…The instability was involuntary in all cases. A positive physical examination for posterior instability was defined as a positive jerk 18 and/or posterior apprehension test 19 .Apositive physical examination for anterior instability was defined as a positive apprehension test and a positive hyperabduction test 20 . Recurrence was defined as repeated episodes of instability associated with positive physical findings for recurrent anterior or posterior instability .S u b l u x a t i o nw a sd e fined as the subjective sensation of the humerus slipping out of the joint followed by spontaneous reduction 21 .…”

Section: Study Populationmentioning

confidence: 99%

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Meyer

Ernstbrunner

Boyce

et al. 2019

The Journal of Bone and Joint Surgery

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BACKGROUND The purpose of this paper was to determine whether acromial morphology influences anteroposterior shoulder stability. We hypothesized that a more horizontal and higher position of the acromion in the sagittal plane would be associated with posterior instability. METHODS In this retrospective study, patients with unidirectional posterior instability were age and sex-matched to a cohort of patients with unidirectional anterior instability. Both cohorts were compared with a control group of patients with no instability and no degenerative glenohumeral (rotator cuff and/or joint surface) or acromial changes. Measurements on radiographs included posterior acromial tilt, anterior and posterior acromial coverage (AAC and PAC), posterior acromial height (PAH), and the critical shoulder angle (CSA). RESULTS The number of patients enrolled in each instability group was 41, based on a priori power analysis. The control group consisted of 53 shoulders. Of the measured anatomic factors, PAH showed the most significant association with posterior instability (odds ratio [OR] = 1.8; p < 0.001) in the logistic regression model. PAH was significantly greater in the posterior instability group compared with the anterior instability group (30.9 versus 19.5 mm; p < 0.001). With a cutoff value of PAH of 23 mm, the OR for posterior instability was 39. Shoulders with posterior instability were also significantly different from normal shoulders with regard to PAH (p < 0.001), AAC (p < 0.001), and PAC (p < 0.001) whereas, in the shoulders with anterior instability, all of these values except the AAC (p = 0.011) did not differ from those of normal shoulders. CONCLUSIONS Specific acromial morphology is significantly associated with the direction of glenohumeral instability. In shoulders with posterior instability, the acromion is situated higher and is oriented more horizontally in the sagittal plane than in normal shoulders and those with anterior instability; this acromial position may provide less osseous restraint against posterior humeral head translation. A steep "Swiss chalet roof-type" acromion virtually excluded recurrent posterior instability in an albeit relatively small cohort of patients. Additional investigation is needed to determine the relevance of these findings for future treatment. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Study Populationmentioning

confidence: 99%

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Meyer

Ernstbrunner

Boyce

et al. 2019

The Journal of Bone and Joint Surgery

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“…A sudden clunk or jerk as the humeral head slides off the back of the glenoid is a positive result. Kim et al 25 concluded that in a shoulder with symptomatic posteroinferior instability the presence of pain when the jerk test was performed was indicative of a posteroinferior labral lesion. Pain with the jerk test was 89.7% sensitive and 85% specific, with a positive predictive value of 72% and a negative predictive value of 94% (Fig.…”

Section: The Jerk Testmentioning

confidence: 99%

Clinical assessment of posterior shoulder joint instability

Funk

Owen

Bonner

2014

Journal of Arthroscopy and Joint Surgery

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a b s t r a c tPosterior shoulder instability is less common than anterior and is not as readily recognised.There are numerous clinical tests for posterior instability. They all have benefits and disadvantages, depending on the type of instability and strength of the patient. In this article we describe the most common clinical tests for posterior instability and review the literature supporting each test. In this manner, we hope that this will provide the clinician with a better understanding of each test and it's value.

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“…There was Grade II laxity on load and shift testing (Hawkins et al, 1984). Speed's test (Bennett, 1998) was negative, there was no tenderness to palpation in the bicipital groove, and the jerk test (Kim et al, 2004) was positive.…”

Section: Case Presentationmentioning

confidence: 99%

Absence of the long head of the biceps tendon associated with glenoid dysplasia and posterior labral tear

et al. 2008

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Anatomic variations in the insertion of the long head of the biceps tendon and superior labral complex have been described (Erickson et al. [1992] AJR Am. J. Roentgenol. 158:1091-1096; Kreitner et al. [1998] AJR Am. J. Roentgenol. 170:599-605; Mariani et al. [1997] Arthroscopy 13:499-501; Vangsness Jr. et al. [1994] J. Bone Joint Surg. Br. 76:951-954). To the authors' knowledge, there have been only five reported cases of congenital absence of the long head of the biceps tendon. Three of these cases were associated with anterior shoulder instability, one with a superior labral anterior posterior lesion and one simply with shoulder pain. This is the first reported case of congenital absence of the biceps tendon associated with glenoid dysplasia and a posterior labral tear.

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Painful Jerk Test: A Predictor of Success in Nonoperative Treatment of Posteroinferior Instability of the Shoulder

Cited by 24 publications

References 7 publications

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability

Clinical assessment of posterior shoulder joint instability

Absence of the long head of the biceps tendon associated with glenoid dysplasia and posterior labral tear

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