DIAGNOSTIC-VALUE OF CLINICAL-TESTS FOR SHOULDER IMPINGEMENT SYNDROME

Results of three clinical tests for detecting shoulder impingement syn drome (Neer's, Hawkins', and Yocum's tests) and four tests for determi ning the location of the rotator cuff lesion (Jobe's test [supraspinat us], Patte's test [infraspinatus], lift-off test [subscapularis], and palm-up test [long head of the biceps brachii]) were compared to intra operatively observed anatomic lesions in 55 consecutive patients who h ad surgery for Neer's syndrome. For Jobe's and Patte's tests, both pai n (denoting tendinitis) and functional impairment (denoting tendon rup ture) were evaluated. All clinical tests were done by the same examine r and all surgical procedures (acromioplasty with or without rotator c uff repair) by the same surgeon, The location and extent of the lesion s (size of the tear in the 34 patients with rotator cuff defects) were determined intraoperatively. The sensitivity, specificity, and positi ve and negative predictive values of each test were calculated. Sensit ivity was satisfactory but specificity was poor, in particular for det ermining the location and type of rotator cuff lesions. The severity o f functional impairment during Jobe's and Patte's maneuvers was not co rrelated with the size of the tear.