Zou A-Peng, An Feng-Min, Xin Yun-Qiang
Department of Sports Medicine and Joint Surgery, Yantai Hospital Affiliated to Binzhou Medaical University, Yantai 264000, Shandong, China.
Zhongguo Gu Shang. 2022 Mar 25;35(3):220-4. doi: 10.12200/j.issn.1003-0034.2022.03.005.
To investigate the diagnostic value of 6 conventional physical examination tests for the diagnosis of supraspinatus tendon tears, and how well they could tell the difference between partial-and full-thickness tears.
A total of 91 patients with different shoulder symptoms who received shoulder arthroscopic procedure were enrolled in the study from June 2017 to September 2020. The intraoperative findings were compared with the results of the preoperative physical examination of 6 clinical tests, including the Hug-up test, the Jobe test, the 0°abduction test, the drop arm test, the Neer test, and the Hawkins test, to determine the sensitivity, specificity, positive and negative predictive value, accuracy, positive and negative likelihood ratio of each test.
By arthroscopy, a total of 44 full-thickness tears, 34 partial-thickness tears, and 13 intact supraspinatus tendons were found in all 91 cases. The Hug-up and the Jobe tests significantly correlated with the intraoperative findings. The sensitivity of the Hug-up test, the Jobe test, the 0° abduction test, the drop arm test, the Neer test, and the Hawkins test was 0.90, 0.79, 0.64, 0.42, 0.49, 0.24 respectively;the specificity was 0.61, 0.69, 0.54, 0.38, 0.31, 0.77;the positive predictive value was 0.93, 0.94, 0.89, 0.80, 0.81, 0.86;the negative predictive value was 0.50, 0.36, 0.20, 0.10, 0.09, 0.14;the accuracy was 0.86, 0.78, 0.63, 0.42, 0.46, 0.32;the positive likelihood ratio was 2.30, 2.58, 1.39, 0.69, 0.71, 1.06;and the negative likelihood ratio was 0.16, 0.30, 0.67, 1.50, 1.65, 0.98.
The Jobe test and the Hug-up test are both effective at accurately diagnosing supraspinatus tendon tears, the Hug-up test detects supraspinatus tears with a high sensitivity, and similar specificity. The tests assessed in this study are not capable of distinguish between partial-and full thickness supraspinatus tendon tears.
探讨6项传统体格检查试验对诊断冈上肌腱撕裂的价值，以及它们区分部分厚度和全层厚度撕裂的能力。
2017年6月至2020年9月，共纳入91例接受肩关节镜手术的有不同肩部症状的患者。将术中发现与6项临床检查（包括搭肩试验、乔布试验、0°外展试验、落臂试验、尼尔试验和霍金斯试验）的术前体格检查结果进行比较，以确定每项试验的敏感性、特异性、阳性和阴性预测值、准确性、阳性和阴性似然比。
通过关节镜检查，在所有91例病例中，共发现44例全层撕裂、34例部分厚度撕裂和13例冈上肌腱完整。搭肩试验和乔布试验与术中发现显著相关。搭肩试验、乔布试验、0°外展试验、落臂试验、尼尔试验和霍金斯试验的敏感性分别为0.90、0.79、0.64、0.42、0.49、0.24；特异性分别为0.61、0.69、0.54、0.38、0.31、0.77；阳性预测值分别为0.93、0.94、0.89、0.80、0.81、0.86；阴性预测值分别为0.50、0.36、0.20、0.10、0.09、0.14；准确性分别为0.86、0.78、0.63、0.42、0.46、0.32；阳性似然比分别为2.30、2.58、1.39、0.69、0.71、1.06；阴性似然比分别为0.16、0.30、0.67、1.50、1.65、0.98。
乔布试验和搭肩试验在准确诊断冈上肌腱撕裂方面均有效，搭肩试验检测冈上肌腱撕裂具有较高敏感性和相似特异性。本研究评估的试验无法区分冈上肌腱部分厚度和全层厚度撕裂。
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