Diagnostic Accuracy of Physical Examinations in Impingement Syndrome and Rotator Cuff Tear

충돌 증후군과 회전근 개 파열을 위한 이학적 검사들의 진단적 가치에 대한 분석

Purpose: The aim of this study was to investigate the diagnostic accuracy of Neer, Hawkins provocative tests and supraspinatus manual muscle test for the assessment of impingement syndrome, partial tear and small complete tear of De rotator cuff. Materials and Methods: Seventy-one female and 115 male patients were included in the study. Patients were divided into four groups of no impingement, impingement without tear, partial tear and small complete tear of the rotator cuff, which were confirmed by sonogram, magnetic resonance imaging and surgery. Neer and Hawkins provocative tests and supraspinatus manual muscle test were performed respectively. SAS 6.12 version was used in statistical analysis. Results: We found that Neer test had 94% sensitivity, 54% specificity for impingement without tear and 89% sensitivity, 78% specificity for partial tear and 96% sensitivity, 23% specificity for small tear. Hawkins test revealed 95% sensitivity, 54% specificity for impingement without tear and 93% sensitivity, 78% specificity for partial tear and 100% sensitivity, 23% specificity for small tear. Supraspinatus manual muscle test revealed 27% sensitivity, 94% specificity for impingement without tear and 29% sensitivity, 82% specificity for partial tear and 48% sensitivity, 82% specificity for small tear. Conclusion: Neer and Hawkins tests have high sensitivity, low specificity for impingement syndrome, partial and small tear. Supraspinatus manual muscle test had low sensitivity and high specificity. However this test was not effective to differentiate the partial and small rotator cuff tear. We thought that more effective provocative test should be designed to detect the partial and small rotator cuff tear.