Comparison of Physical Examinations and Ultrasonographic Findings in Patients with Painful Shoulder
Main Article Content
Abstract
Background with Objective: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder. The aim of this study was to compare the physical examinations with ultrasonographic findings in patients with painful shoulder.
Methods: This Prospective observational Study was carried out among 101 patients attending at the Department of Physical Medicine and Rehabilitation, Dhaka Medical College and Hospital (DMCH), Dhaka within the defined period from July 2021 to December 2021. Ethical clearance was obtained from the Ethical review committee of Dhaka Medical College Hospital. Purposive sampling was done according to availability of the patients. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.1).
Results: Majority of the patients (59.4%) were in 41-50 years age group where the mean age of the patients was 50.3 ± 7.9 years and 51 (50.5%) patients were male. On physical examination, 76 (75.2%) patients were Neer tests positive, 62 (61.4%) were Jobe’s test for supraspinatus positive and 37 (36.6%) were Yegarson’s test for the long head of the biceps brachii positive. Most of the patients (93.1%) were Patte’s test for infraspinatus negative. USG findings shows that 47 (46.5%) had impingement, 30 (29.7%) had Osteoarthritis in acromioclavicular joint, another 30 (29.7%) had Supranpinatous tendinosis, 25 (24.8%) had Subdeltoid bursitis, 22 (21.8%) had partial tear of supraspinatous. Neer tests had 47.4% sensitivity and 56.0% specificity with 49.5% accuracy. Jobe’s test for supraspinatus had 66.7% sensitivity and 40.8% specificity with 48.5% accuracy. Patte’s test for infraspinatus had 95.8% accuracy and Gerber’s lift-off test for subscapularis had 84.1% accuracy while Yegarson’s test for the long head of the biceps brachii had 79.2% accuracy
Conclusion: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Leroux JL, Thomas E, Bonnel F, Blotman F. Diagnostic value of clinical tests for shoulder impingement syndrome. Revue du rhumatisme (English ed.). 1995; 62(6):423-8.
II. Naredo E, Aguado P, De Miguel E, Uson J, Mayordomo L, Gijon-Banos J, Martin-Mola E. Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann. Rheum. Dis. 2002; 61(2):132-6.
III. Wise JN, Daffner RH, Weissman BN, Bancroft L, Bennett DL, Blebea JS, Bruno MA, Fries IB, Jacobson JA, Luchs JS, Morrison WB. ACR Appropriateness Criteria® on acute shoulder pain. J Am Coll Radiol. 2011; 8(9):602-9.
IV. Tandon A, Dewan S, Bhatt S, Jain AK, Kumari R. Sonography in diagnosis of adhesive capsulitis of the shoulder: a case–control study. J. Ultrason. 2017; 20(3):227-36.
V. Park GY, Park JH, Kwon DR, Kwon DG, Park J. Do the findings of magnetic resonance imaging, arthrography, and ultrasonography reflect clinical impairment in patients with idiopathic adhesive capsulitis of the shoulder?. Arch. Phys. Med. Rehabil. 2017; 98(10):1995-2001.
VI. Micheroli R, Kyburz D, Ciurea A, Dubs B, Toniolo M, Bisig SP, Tamborrini G. Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder. J. Ultrason. 2015; 15(60):29-44.
VII. Saulle M, Gellhorn AC. Approach to the diagnosis of shoulder pain using physical exam and ultrasound: an evidence-based approach. Curr. Phys. Med. Rehabil. Rep. 2017;5(1):1-11.
VIII. Coari G, Paoletti F, Iagnocco A. Shoulder involvement in rheumatic diseases. Sonographic findings. J. Rheumatol. 1999; 26(3):668-73.
IX. Khan MSZ, Rahman N, Ferdousi MA, Khatoon R, Taher MA. Ultrasonographic findings in patients with shoulder pain. BIRDEM Med J. 2019; 9(3): 218-22.
X. Choi YH, Kim DH. Correlations between clinical features and MRI findings in early adhesive capsulitis of the shoulder: a retrospective observational study. BMC Musculoskeletal Disorders. 2020 Dec; 21(1):1-9.
XI. Kim HA, Kim SH, Seo YI. Ultrasonographic findings of painful shoulders and correlation between physical examination and ultrasonographic rotator cuff tear. Modern Rheumatology. 2007; 17(3):213-9.
XII. Deshpande SV, Phatak SV, Marfani GB, Gupta NA, Daga SS, Samad SS. Sonographic evaluation of painful shoulder and its comparison with clinical diagnosis. Journal of Datta Meghe Institute of Medical Sciences University. 2018;13(1):12.
XIII. Patidar M, Patil A, Verma V, Kaushal L. Evaluation of painful shoulder with high frequency sonography and their comparison with the clinical diagnosis made by physical examination. NJR 2012;2:43‑50.
XIV. Gschwend N, Ivosevic-Radovanovic, Patte D. Rotator cuff tear: relationship between clinical and anatomo-pathological findings. Arch Orthop Trauma Surg 1988;107:7-15
XV. Norwood LA, Barrack R, Jacobson KE. Clinical presentation of complete tear of the rotator cuff. J Bone Joint Surg [Am] 1989;71:499-505
XVI. Leroux JL, Thomas E, Bonnel F, Blotman F. Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum (Engl Ed) 1995;62:423–8
XVII. Norwood LA, Barrack R, Jacobson KE. Clinical presentation of complete tear of the rotator cuff. J Bone Joint Surg [Am] 1989;71:499-505