Rheumatology and Rehabilitation Department, Al-Azhar University, Cairo, Egypt.
Rheumatology and Rehabilitation Department, Al-Azhar University, Assiut, Egypt.
BMC Musculoskelet Disord. 2024 Nov 21;25(1):940. doi: 10.1186/s12891-024-08013-9.
Several tests have been suggested for screening and diagnosis of cervical spine and shoulder girdle conditions underlying shoulder pain with variable degrees of clinical accuracy. The present study aimed to test the reliability, clinical benefit and screening value of the Swimmer Arm-to-Shoulder (SAS) test; a new clinical test developed to differentiate shoulder impingement from cervical radiculopathy in patients with shoulder pain of ≤ 12 weeks.
The study included 718 patients aged 40-65 years, with unilateral and localized shoulder girdle pain lasting for ≤ 12 weeks. Diagnosis based on clinical, electromyography and radiological findings was considered as the reference gold standard for test assessment.
Clinical diagnosis identified shoulder pathology in 288 patients (40.1%) and cervical spine pathology in 430 patients (59.9%). SAS test was positive in 274 patients (38.2%). The SAS test proved to be effective in distinguishing shoulder from cervical spine pathology with a sensitivity of 89.2% (95% CI: 85.0-92.6%), specificity of 96.1% (95% CI: 93.8-97.7%), PPV of 93.8% (95% CI: 90.5-96.0%), NPV of 93.0% (95% CI: 90.5-94.9%), LR + of 22.6% (95% CI: 14.1-36.0%), LR- of 0.11 (95% CI: 0.08-0.16) and accuracy of 93.3% (95% CI: 91.2-95.0%).
SAS test is an easy to perform, patient dependent and reliable as a screening test and diagnosis confirmatory test.
有几种测试已被建议用于筛查和诊断颈椎和肩部疾病引起的肩部疼痛，其临床准确性各不相同。本研究旨在测试游泳者手臂到肩部（SAS）测试的可靠性、临床获益和筛查价值；这是一种新的临床测试，用于区分肩部撞击和颈椎病，适用于肩部疼痛持续时间≤ 12 周的患者。
该研究纳入了 718 名 40-65 岁、单侧和局限性肩部疼痛持续时间≤ 12 周的患者。以临床、肌电图和影像学检查结果为基础的诊断被认为是测试评估的参考金标准。
临床诊断发现 288 例（40.1%）患者存在肩部病变，430 例（59.9%）患者存在颈椎病变。SAS 测试阳性者 274 例（38.2%）。SAS 测试在区分肩部和颈椎病变方面非常有效，其敏感性为 89.2%（95%可信区间：85.0-92.6%），特异性为 96.1%（95%可信区间：93.8-97.7%），PPV 为 93.8%（95%可信区间：90.5-96.0%），NPV 为 93.0%（95%可信区间：90.5-94.9%），LR+为 22.6%（95%可信区间：14.1-36.0%），LR-为 0.11（95%可信区间：0.08-0.16），准确率为 93.3%（95%可信区间：91.2-95.0%）。
SAS 测试是一种易于操作、依赖于患者的可靠测试，既可以作为筛查测试，也可以作为诊断确认测试。
