Diagnostic Value of Clinical Tests in Patients with Rotator Cuff Arthropathy

Abstract

Relevance. There are a large number of clinical tests for the diagnosis of rotator cuff tendon injuries and their consequences. Timely collected anamnesis and a thorough clinical examination are the key to an accurate diagnosis and the choice of treatment tactics. Objective: to determine the diagnostic value of clinical tests in patients with rotator cuff arthropathy. Materials and Methods. Clinical examination and surgical treatment of 110 patients with pathology of the shoulder joint, who had limited or complete lack of movement in the shoulder joint. The study of clinical results was performed in 2 groups: group I (60 patients) with rotator cuff arthropathy and group II (50 patients) with osteonecrosis of the humeral head. All patients were examined according to a single standard (clinical, radiological, and MRI examination). The clinical examination was performed in the standard way with special tests: the Jobe test, the Neer test, the Full can test, the Patte test, the Lift-off test, and the Hawkins-Kennedy test. Results and Conclusions. As a result of the analysis of clinical research data in patients with rotator cuff arthropathy, it was established that the clinical picture was distinguished by the polymorphism of manifestations and was closely related to undiagnosed damage to the structures of the shoulder joint. In patients with rotator cuff arthropathy, the most informative tests were (1) the Lift-off test: sensitivity (95.45%), specificity (73.33%), accuracy (86.49%), positive predictive value (PVP) (84.00%) and negative predictive value (PVN) (91.67%), and (2) the Full can test: sensitivity (89.80%), specificity (72.50%), accuracy (82.02%), as well as PVP (80.00%) and PVN (85.29%). In patients with rotator cuff arthropathy, the pain syndrome remained in most cases, which increased the sensitivity of the Lift-off test to 95.45% and the Full can test to 89.80%. The least specific clinical tests in patients with rotator cuff arthropathy were the Patte test (63.83%) and the Hawkins-Kennedy test (58.82%). No clinical test is reliable enough to diagnose rotator cuff arthropathy or osteonecrosis.