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

Hanchard, Nigel; Handoll, HHG

doi:10.1002/14651858.cd007427

Cited by 41 publications

(54 citation statements)

References 40 publications

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“…In a Cochrane review of RCTs, Hanchard et al 112 investigated the accuracy of physical tests for SIS and other shoulder pathologies. When a combination of seven positive tests was used, the sensitivity estimate was 5% [95% confidence interval (CI) 1% to 11%] and specificity estimate was 97% (95% CI 86% to 100%).…”

Section: Discussionmentioning

confidence: 99%

“…When only a combination of a positive Hawkins' test or Neer's sign was used, the sensitivity estimates increased markedly to 96% (95% CI 79% to 100%) and specificity estimates fell to 41% (95% CI 29% to 54%). 112 Although the combination of the two most commonly used index tests was found to be highly sensitive in detecting impingement sign, a large number of false positives were observed. Hanchard et al 112 concluded that there are no strong index tests for diagnosing impingement and that greater emphasis should be placed on making a diagnosis based on the exclusion of other shoulder pathologies.…”

Section: Discussionmentioning

confidence: 99%

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Shoulder impingement syndrome: a systematic review of clinical trial participant selection criteria

et al. 2016

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Background: Shoulder impingement syndrome (SIS) is a common diagnosis for patients with pain and dysfunction of the shoulder. Variations in the signs and symptoms might lead to uncertainty regarding the definition of SIS. The aim of this review is to explore the participant selection criteria used in the literature when investigating SIS and to assess differences in criteria among treating professions. Methods: This is a PRISMA systematic review of publications from 2009 to 2014 from MEDLINE, PubMed, The Cochrane Library, Embase, Scopus and CINAHL. Results: Ninety-seven articles met inclusion criteria for this review. Twenty-five different surgical and nonsurgical treatments were investigated. Impingement-specific index tests were used in all studies. Exclusion index tests were used in 62% of studies. Twenty index tests were identified. Radiological investigations were reported in 53% of all studies, of which a further 53% reported using two or more radiological investigations. Conclusions: This systematic review has illustrated that studies investigating SIS test for various signs and symptoms, which is in keeping with describing the condition as a 'syndrome'. However, there are inconsistencies in participant selection criteria between health disciplines, highlighting a need for harmonization of the selection criteria in the form of an international editorial consensus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Shoulder impingement syndrome: a systematic review of clinical trial participant selection criteria

et al. 2016

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“…None of the many specific clinical examination tests suggested for diagnosing shoulder and neck pain has high sensitivity and specificity. 1,2 Pain referred from the neck is often associated with neck movement and sometimes with nerve root compression producing paraesthesia, weakness, and altered tendon reflexes. Spurling's test (pain when extending and rotating the head to the affected side while pressing down on the head) might further help indicate cervical radiculopathy, with low to moderate sensitivity (30-90%) and high specificity (74-100%).…”

Section: Examinationmentioning

confidence: 99%

“…3 Clinical tests to diagnose ACJ disorder are of limited diagnostic value. 2 Exclusive tenderness over the joint has a high sensitivity of 90-95%, however it has a poor specificity of 10%. The cross adduction test (pain when bringing arms across chest to touch the opposite shoulder) has sensitivity of 77-100% and specificity of 79%.…”

Section: Examinationmentioning

confidence: 99%