Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome

Objective-Subacromial impingement syndrome (SIS) is a frequent cause of sho ulder pain. The aim of this study was to investigate the diagnostic values of clinical diagnostic tests, in patients with SIS. Methods-72 female, 48 male patients with shoulder pain were included in the study. Five had bilateral shoulder pain, so 125 painful shoulders were eva luated. Details were recorded about the patients' ages and sexes, as well a s characteristics of pain and related problems. Detailed physical examinati on and routine laboratory tests were performed. Conventional radiography an d subsequent magnetic resonance imaging of the shoulder region of all patie nts were performed. Patients were divided into two groups according to the results of subacromial injection test, a reference standard test for SIS. T est positive patients constituted SIS group and test negative patients the non-SIS group. Sensitivity, specificity, accuracy, positive and negative pr edictive values of some clinical diagnostic tests such as Neer, Hawkins, ho rizontal adduction, painful are, drop arm, Yergason and Speed tests for SIS were determined by using 2 x 2 table. Results-The most sensitive diagnostic tests were found to be Hawkins test ( 92.1%), Neer test (88.7%) and horizontal adduction test (82.0%). Tests with highest specificity were drop arm test (97.2%), Yergason test (86.1%) and painful are test (80.5%) consecutively. Conclusion-The highly sensitive tests seem to have low specificity values a nd the highly specific ones to have low sensitivity values. Although this f inding suggests that these diagnostic tests are insufficient for certain di agnosis, it is suggested they play an important part in clinical evaluation .