Clinical tests for the diagnosis of rotator cuff disease

• Published in: Sports medicine and arthroscopy review Vol. 19; no. 3; p. 266
• Main Authors: Longo, Umile Giuseppe, Berton, Alessandra, Ahrens, Philip Michael, Maffulli, Nicola, Denaro, Vincenzo
• Format: Journal Article
• Language: English
• Published: United States 01.09.2011
• Subjects: Female; Humans; Male; Reproducibility of Results; Rotator Cuff - anatomy & histology; Rotator Cuff Injuries; Sensitivity and Specificity; Shoulder - anatomy & histology; Shoulder Impingement Syndrome - diagnosis; Shoulder Pain - diagnosis; Tendon Injuries - diagnosis
• ISSN: 1538-1951
• DOI: 10.1097/JSA.0b013e3182250c8b

Several tests have been described to examine the shoulder. However, there is a lack of consensus on clinical assessment of patients with shoulder pain and suspected rotator cuff pathology. This review reports the diagnostic accuracy of clinical tests for rotator cuff pathology. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 21 clinical tests for rotator cuff pathology are reported from the available literature. Twenty studies investigated supraspinatus pathology, 12 infraspinatus pathology, and 9 subscapularis pathology. Most tests for rotator cuff pathology are inaccurate, and the recent literature shows that there is insufficient evidence to recommend 1 clinical test over another for diagnosis of rotator cuff pathology. Poor diagnostic accuracy of clinical tests for rotator cuff pathology may be related to the close relationships of structures in the shoulder, to a lack of understanding of anatomical basis of the tests, or to their lack of reproducibility.