Test Item Cluster - Full-Thickness Rotator Cuff Tear: Difference between revisions

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= '''Purpose'''<br>  =
<div class="editorbox">
'''Original Editor '''- [[User:Jun Cesar Atienza|Jun Cesar Atienza]]


To test the presence of a shoulder full-thickness rotator cuff tear using the [http://www.physio-pedia.com/index.php5?title=Codman%27s_Test The Drop-Arm Sign],&nbsp; [http://www.physio-pedia.com/index.php5?title=Painful_Arc The Painful Arc Sign], and the [http://www.physio-pedia.com/index.php5?title=Infraspinatus_Test Infraspinatus Muscle Test]. <br>  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} 
</div>


= '''Evidence''' =
== Purpose ==


Based on the Park et al<ref name="Park">Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg AmfckLR2005 July;87(7):1446-55.</ref> study, the combination of the following 3 special tests have produced the highest post-test probability to diagnose a full-thickness rotator cuff tear:<br>  
To test the presence of a shoulder full-thickness rotator cuff tear using the [[Codman's Test|Drop-Arm Sign]], [[Painful Arc|Painful Arc Sign]], and the [[Infraspinatus Test|Infraspinatus Muscle Test]].<br>  


== Evidence  ==
Based on the Park et al<ref name="Park">Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg AmfckLR2005 July;87(7):1446-55.</ref> study, the combination of the following 3 special tests have produced the highest post-test probability to diagnose a full-thickness rotator cuff tear:
#The Drop-Arm Sign  
#The Drop-Arm Sign  
#The Painful Arc Sign  
#The Painful Arc Sign  
#Infraspinatus Muscle Test
#Infraspinatus Muscle Test


The study concluded that if all 3 tests were positive, the probabibility of the patient having a full-thickness rotator cuff tear is 91%.<ref name="Park">Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 2005 July;87(7):1446-55.</ref><br>  
The study concluded that if all 3 tests were positive, the probability of the patient having a full-thickness rotator cuff tear is 91%.<ref name="Park" /><br>  
 
= '''Description and Illustrations'''<br> =


== Description and Illustrations  ==
<u>The Drop-Arm Sign</u>  
<u>The Drop-Arm Sign</u>  


Patient actively elevates the arm in the scapular plane and then slowly reverses the motion.&nbsp; A positive test is defined as the patient experiencing pain during the activity or that the arm suddenly drops.  
Patient actively elevates the arm in the scapular plane and then slowly reverses the motion.&nbsp; A positive test is defined as the patient experiencing pain during the activity or that the arm suddenly drops.<br>


<br> <u>The Painful Arc Sign </u>(Fig 1)  
<u>The Painful Arc Sign </u>(Fig 1)  


<u></u>Patient fully elevates the arm along the scapular plane and then slowly reverses the motion.&nbsp; If patient experiences pain between 60° and 120° of range of motion, the test is considered positive.<br>  
Patient fully elevates the arm along the scapular plane and then slowly reverses the motion. If patient experiences pain between 60° and 120° of range of motion, the test is considered positive.<br>  


<u></u>


<u>[[Image:Painful arc.jpg|Image:Painful_arc.jpg]]</u>  
<u>[[Image:Painful arc.jpg|Image:Painful_arc.jpg]]</u>  


''Figure 1 (couresty of [http://www.maitrise-orthop.com/photos/168/cdumontier_doursounian_miseaupoint_1010/fig14dumontier.jpg http://www.maitrise-orthop.com])''  
''Figure 1 (couresty of [http://www.maitrise-orthop.com/photos/168/cdumontier_doursounian_miseaupoint_1010/fig14dumontier.jpg http://www.maitrise-orthop.com])'' <br>
 
<br> <u></u>  


<u>Infraspinatus Muscle Test </u>(Fig 2)  
<u>Infraspinatus Muscle Test </u>(Fig 2)  
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[[Image:Infraspinatus test.jpg|Image:Infraspinatus_test.jpg]]<br>  
[[Image:Infraspinatus test.jpg|Image:Infraspinatus_test.jpg]]<br>  


''Figure 2 (taken directly from Park et al''<ref name="Park">Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 2005 July;87(7):1446-55.</ref>)<br>
''Figure 2 (taken directly from Park et al''<ref name="Park" />)<br>  
 
<u></u>
 
<br>  


= '''References''' =
== References  ==


#Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 2005 July;87(7):1446-55. [http://www.jbjs.org/Comments/pdf/JBJA087071446.pdf www.jbjs.org/Comments/pdf/JBJA087071446.pdf]
<references />


[[Category:EIM_Student_Project_2|<br>]]
[[Category:Assessment]]
[[Category:Special_Tests]] 
[[Category:Shoulder]]
[[Category:Shoulder - Special Tests]]
[[Category:Shoulder - Assessment and Examination]] 
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:EIM_Residency_Project]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Clinical Prediction Rules]]

Latest revision as of 16:16, 29 August 2019

Purpose[edit | edit source]

To test the presence of a shoulder full-thickness rotator cuff tear using the Drop-Arm Sign, Painful Arc Sign, and the Infraspinatus Muscle Test.

Evidence[edit | edit source]

Based on the Park et al[1] study, the combination of the following 3 special tests have produced the highest post-test probability to diagnose a full-thickness rotator cuff tear:

  1. The Drop-Arm Sign
  2. The Painful Arc Sign
  3. Infraspinatus Muscle Test

The study concluded that if all 3 tests were positive, the probability of the patient having a full-thickness rotator cuff tear is 91%.[1]

Description and Illustrations[edit | edit source]

The Drop-Arm Sign

Patient actively elevates the arm in the scapular plane and then slowly reverses the motion.  A positive test is defined as the patient experiencing pain during the activity or that the arm suddenly drops.

The Painful Arc Sign (Fig 1)

Patient fully elevates the arm along the scapular plane and then slowly reverses the motion. If patient experiences pain between 60° and 120° of range of motion, the test is considered positive.


Image:Painful_arc.jpg

Figure 1 (couresty of http://www.maitrise-orthop.com)

Infraspinatus Muscle Test (Fig 2)

Arm is resting in neutral, the patient is instructed to flex elbow to 90° and resist against applied resistance mediall.  If the patient is unable to resist the force or experiences pain, the test is considered positive.

Image:Infraspinatus_test.jpg

Figure 2 (taken directly from Park et al[1])

References[edit | edit source]

  1. 1.0 1.1 1.2 Park HB, Yokota A, Gill HS, El RG, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg AmfckLR2005 July;87(7):1446-55.