Stetson William B, Templin Kevin
University of Southern California, Department of Orthopedics, Los Angeles, California, USA.
Am J Sports Med. 2002 Nov-Dec;30(6):806-9. doi: 10.1177/03635465020300060901.
Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically.
We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears.
Nonrandomized prospective study.
Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain.
The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%.
The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.
肩关节上盂唇从前向后的撕裂在临床上难以诊断。
我们研究了曲柄试验或奥布赖恩试验是否为检测肩胛盂唇撕裂的可靠工具。
非随机前瞻性研究。
对65例有肩部疼痛症状的患者，将诊断性肩关节镜检查结果与术前试验及磁共振成像结果进行比较。
曲柄试验结果阳性的有29例患者（45%），奥布赖恩试验结果阳性的有41例患者（63%）。曲柄试验的阳性预测值为41%，特异性为56%，敏感性为46%，阴性预测值为61%。奥布赖恩试验的阳性预测值为34%，特异性为31%，敏感性为54%，阴性预测值为50%。磁共振成像的阳性预测值为63%，特异性为92%，敏感性为42%，阴性预测值为83%。
奥布赖恩试验和曲柄试验并非检测肩胛盂唇撕裂及其他前后盂唇撕裂的敏感临床指标。对于患有其他肩部疾病（包括撞击或肩袖撕裂）的患者，结果常出现假阳性。
