Guosheng Yu, Chongxi Ren, Guoqing Cui, Junling Xu, Hailong Ji
Department of Orthopedics, Cangzhou Clinical College of Integrated Traditional Chinese and Western Medicine of Hebei Medical University, Qian Tong North Street No. 17, Cangzhou City, 061000, Hebei Province, China.
Department of Orthopedics, Peking University Institute of Sports Medicine, Beijing, 100083, China.
Eur J Orthop Surg Traumatol. 2017 Dec;27(8):1063-1067. doi: 10.1007/s00590-017-1979-8. Epub 2017 May 22.
Subacromial impingement syndrome (SAIS) is characterized by pain experienced through an arc of elevation as the shoulder abducts and diagnosed commonly by Neer test (NT). However, the diagnostic accuracy of NT for SAIS is still limited. Here, a modified Neer test (MNT) was introduced to improve the accuracy of the clinical examination in diagnosing SAIS and differentiating it from frozen shoulder. The aim of this study was to investigate the diagnostic values of MNT in diagnosing SAIS and differentiating it from frozen shoulder.
Between January 2015 and June 2015, a prospective study assessed 85 shoulders among 82 patients with shoulder joint disease; 42 patients underwent arthroscopic surgery, and all 82 patients received X-rays, magnetic resonance imaging (MRI) or MRI contrast examinations. The diagnostic criteria are based on arthroscopy and MRI scanning.
Using clinical epidemiology and diagnostic tests, we calculated the sensitivity, specificity, positive predictive value, negative predictive value and degree of accuracy of MNT in diagnosing SAIS. The diagnostic accuracy rate of MNT in identifying shoulder SAIS was 90.59%, and the specificity was 95.56%.
In the diagnosis of SAIS, MNT is a reliable and highly accurate maneuver and seems useful to distinguish this syndrome from frozen shoulder.
肩峰下撞击综合征（SAIS）的特征是在肩部外展时通过抬高弧体会感到疼痛，通常通过Neer试验（NT）进行诊断。然而，NT对SAIS的诊断准确性仍然有限。在此，引入了改良Neer试验（MNT）以提高临床检查在诊断SAIS以及将其与肩周炎相鉴别时的准确性。本研究的目的是探讨MNT在诊断SAIS以及将其与肩周炎相鉴别时的诊断价值。
在2015年1月至2015年6月期间，一项前瞻性研究评估了82例肩关节疾病患者的85个肩部；42例患者接受了关节镜手术，所有82例患者均接受了X线、磁共振成像（MRI）或MRI造影检查。诊断标准基于关节镜检查和MRI扫描。
使用临床流行病学和诊断试验，我们计算了MNT在诊断SAIS时的敏感性、特异性、阳性预测值、阴性预测值和准确性程度。MNT识别肩部SAIS的诊断准确率为90.59%，特异性为95.56%。
在SAIS的诊断中，MNT是一种可靠且高度准确的手法，似乎有助于将该综合征与肩周炎区分开来。
