Department of Radiology, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2013 Feb;21(2):424-9. doi: 10.1007/s00167-012-1969-7. Epub 2012 Mar 28.
Using sonographic findings to test the diagnostic accuracy of impingement versus tendon palpation tests in Neer stage I and II subacromial impingement syndrome cases and examine their clinical potential.
Neer and Hawkins impingement tests and rotator cuff tendon palpation tests followed by bilateral shoulder sonography were conducted on 69 patients with a clinical diagnosis of unilateral subacromial impingement.
The Neer and Hawkins tests had 74 and 62 % accuracy (sensitivity 80 and 67 %, and specificity 52 and 47 %, respectively) in comparison to 79 and 62 % accuracy rates for supraspinatus and biceps tendon palpation tests (sensitivity 92 and 41 %, and specificity 41 and 48 %, respectively). Overall, the palpation tests scored better than impingement tests in the diagnosis of Neer stage I and II subacromial impingement syndrome. No tendinosis or tear was noted in patients with negative findings in the supraspinatus palpation tests (sensitivity 100 %, specificity 21 %).
Palpation tests for supraspinatus and biceps tendons have a slightly higher accuracy than the impingement tests, and if tenderness does not exist then supraspinatus tendinopathy can be ruled out. These findings warrant the use of palpation tests in a routine physical examination for tendinopathy.
I.
利用超声检查结果，测试撞击试验与冈上肌腱触诊试验在 Neer Ⅰ期和Ⅱ期肩峰下撞击综合征病例中的诊断准确性，并研究其临床应用潜能。
对 69 例单侧肩峰下撞击综合征的患者进行 Neer 撞击试验、Hawkins 撞击试验和冈上肌腱触诊试验，随后对双侧肩关节进行超声检查。
Neer 撞击试验和 Hawkins 撞击试验的准确率分别为 74%和 62%（敏感度分别为 80%和 67%，特异度分别为 52%和 47%），而冈上肌腱和肱二头肌长头肌腱触诊试验的准确率分别为 79%和 62%（敏感度分别为 92%和 41%，特异度分别为 41%和 48%）。总体而言，触诊试验在诊断 Neer Ⅰ期和Ⅱ期肩峰下撞击综合征方面优于撞击试验。在冈上肌腱触诊试验结果为阴性的患者中，未发现肩袖肌腱的退行性变或撕裂（敏感度 100%，特异度 21%）。
冈上肌腱和肱二头肌长头肌腱触诊试验的准确性略高于撞击试验，如果不存在压痛，则可排除冈上肌腱病变。这些发现提示在常规体格检查中可使用触诊试验来检查肌腱病。
I 级。
