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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References  ==


References will automatically be added here, see [[Adding References|adding references tutorial]].
== Purpose  ==


<references />
To test for the presence of [[Rotator Cuff Tears|rotator cuff tears]].<br>  


= Purpose =
== Technique ==


To test for the presence of [[Rotator Cuff Tears|rotator cuff tears]]&nbsp;  
Patient is seated with examiner standing behind patient. Have patient relax - palpate anterior margin of the acromion through the deltoid - while doing this grasp the patient's arm with the other hand at the elbow/forearm (patients elbow should be flexed to ~ 90 degrees) and bring into extension. Passively internally and externally rotate patients arm to palpate rotator cuff tendons. Presence of palpable or prominent eminence (Greater tuberosity) and/or rent (defect or 'sulcus')<ref>Dutton M.  Orthopaedic Examination, Evaluation, and Intervention.  New York:  The McGraw-Hill Companies  (2nd Ed.) 2008</ref> is indicative of full-thickness tear. <ref name="Wolf">[http://www.ncbi.nlm.nih.gov/pubmed/11641706 Wolf EM &amp; Agrawal V.  Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears.  J Shoulder Elbow Surg.  Sept/Oct 2001;10(5):470-473]</ref><ref name="Lyons">[http://www.ncbi.nlm.nih.gov/pubmed/1587891 Lyons AR &amp; Tomlinson JE.  Clinical Diagnosis of Tears of the Rotator Cuff.  J Bone Joint Surg.  May 1991;(74):404-405]</ref><ref name="Cleland">Cleland J.  Orthopaedic Clinical Examination:  An Evidence-Based Approach for Physical Therapists.  Philadelphia; Saunders, Elsevier:  2007</ref><br> {{#ev:youtube|YA6oasQWGFA|300}}<ref>Clinically Relevant Technologies, http://www.youtube.com/watch?v=YA6oasQWGFA, Accessed May 2011</ref>


= Technique<ref>Wolf EM &amp;amp;amp;amp;amp;amp; Agrawal V. Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears. J Shoulder Elbow Surg. Sept/Oct 2001;10(5):470-473</ref><ref>Lyons AR &amp;amp;amp;amp;amp;amp; Tomlinson JE. Clinical Diagnosis of Tears of the Rotator Cuff. J Bone Joint Surg. May 1992;74:404-405</ref><ref>Cleland J. Orthopaedic Clinical Examination: An Evidence Based Approach for Physical Therapists. Philadelphia; Saunders, Elsevier. 2007</ref> =
== Evidence  ==


Patient is seated with examiner standing behind patient.&nbsp; Have patient relax - palpate anterior&nbsp;margin of&nbsp;the acromion through the deltoid - while doing this grasp the patients arm with other hand at the elbow/forearm (patients elbow should be flexed to ~ 90 degrees) and bring into extension.&nbsp; Passively internally and externally rotate patients arm to palpate rotator cuff tendons.&nbsp; Presence of palpable or prominent eminence (Greater tuberosity) and/or rent (defect or 'sulcus')<sup>4</sup> is indicative of full thickness tear. <sup>1,2,3</sup>  
Wolf and Agrawal<sup><ref name="Wolf" /> </sup>report Sensitivity and Specificity of 95.7% (.96<ref name="Cleland" />) and 96.8% (.97<ref name="Cleland" />) respectively with a positive predictive value of 95.7%, negative predictive value of 96.8% and a diagnostic accuracy of 96.3%. Cleland<ref name="Cleland" /> calculates a +LR of 32.0 and -LR of .04.&nbsp; Lyons and Tomlinson<ref name="Lyons" /> reported Sn of 91% (.91) and Sp of 75% (.75).  
<br>


= Evidence  =
== References ==
 
Wolf and Agrawal<sup>1 </sup>report Sensitivity and Specificity of 95.7% (.96<sup>3</sup>) and 96.8% (.97<sup>3</sup>) respectively with a positive predictive value of 95.7%, negative predictive value of 96.8% and a diagnostic accuracy of 96.3%.&nbsp; Cleland<sup>3 </sup>calculates a +LR of 32.0 and -LR of .04.&nbsp; Lyons and Tomlinson<sup>2</sup> reported Sn of 91% (.91) and Sp of 75% (.75).
 
= Resources (from Pubmed)&nbsp; =
 
[http://www.ncbi.nlm.nih.gov/pubmed/11641706 http://www.ncbi.nlm.nih.gov/pubmed/11641706]&nbsp;&nbsp;<sup>1</sup>
 
[http://www.ncbi.nlm.nih.gov/pubmed/1587891 http://www.ncbi.nlm.nih.gov/pubmed/1587891]&nbsp; <sup>2</sup>
 
= References  =
 
<sup>1</sup>Wolf EM &amp; Agrawal V.&nbsp; ''Transdeltoid palpaiton (the rent test) in the diagnosis of rotator cuff tears''.&nbsp; J Shoulder Elbow Surg.&nbsp; Sept/Oct 2001;10(5):470-473
 
<sup>2</sup>Lyons AR &amp; Tomlinson JE.&nbsp; ''Clincial Diagnosis of Tears of the Rotator Cuff''.&nbsp; J Bone Joint Surg.&nbsp; May 1991;(74):404-405
 
<sup>3</sup>Cleland J.&nbsp; Orthopaedic Clinical Examination:&nbsp; An Evidence Based Approach for Physical Therapists.&nbsp; Philadelphia;&nbsp; Saunders, Elsevier:&nbsp; 2007&nbsp;


<sup>4</sup>Dutton M.&nbsp; Orthopaedic Examination, Evaluation, and Intervention.&nbsp; New York: &nbsp;The McGraw-Hill Comapinies&nbsp; (2nd Ed.) 2008
<references />  


[[Category:Shoulder]] [[Category:Special_Tests]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Assessment]] [[Category:EIM_Student_Project_1]]
[[Category:Assessment]]
[[Category:Shoulder]]  
[[Category:Special_Tests]]  
[[Category:Shoulder - Special Tests]]
[[Category:Shoulder - Assessment and Examination]]
[[Category:Musculoskeletal/Orthopaedics]]  
[[Category:EIM_Residency_Project]]
[[Category:Primary Contact]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]

Latest revision as of 16:16, 29 August 2019

Original Editor - Ron Bucholtz

Top Contributors - Ron Bucholtz, Admin, Kim Jackson, WikiSysop, Claire Knott, Wanda van Niekerk, 127.0.0.1, Dan Rhon, Evan Thomas and Naomi O'Reilly

Purpose[edit | edit source]

To test for the presence of rotator cuff tears.

Technique[edit | edit source]

Patient is seated with examiner standing behind patient. Have patient relax - palpate anterior margin of the acromion through the deltoid - while doing this grasp the patient's arm with the other hand at the elbow/forearm (patients elbow should be flexed to ~ 90 degrees) and bring into extension. Passively internally and externally rotate patients arm to palpate rotator cuff tendons. Presence of palpable or prominent eminence (Greater tuberosity) and/or rent (defect or 'sulcus')[1] is indicative of full-thickness tear. [2][3][4]

[5]

Evidence[edit | edit source]

Wolf and Agrawal[2] report Sensitivity and Specificity of 95.7% (.96[4]) and 96.8% (.97[4]) respectively with a positive predictive value of 95.7%, negative predictive value of 96.8% and a diagnostic accuracy of 96.3%. Cleland[4] calculates a +LR of 32.0 and -LR of .04.  Lyons and Tomlinson[3] reported Sn of 91% (.91) and Sp of 75% (.75).

References[edit | edit source]

  1. ↑ Dutton M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies (2nd Ed.) 2008
  2. ↑ 2.0 2.1 Wolf EM & Agrawal V. Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears. J Shoulder Elbow Surg. Sept/Oct 2001;10(5):470-473
  3. ↑ 3.0 3.1 Lyons AR & Tomlinson JE. Clinical Diagnosis of Tears of the Rotator Cuff. J Bone Joint Surg. May 1991;(74):404-405
  4. ↑ 4.0 4.1 4.2 4.3 Cleland J. Orthopaedic Clinical Examination: An Evidence-Based Approach for Physical Therapists. Philadelphia; Saunders, Elsevier: 2007
  5. ↑ Clinically Relevant Technologies, http://www.youtube.com/watch?v=YA6oasQWGFA, Accessed May 2011
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