[논문]Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

Micheroli, Raphael; Kyburz, Diego; Ciurea, Adrian; Dubs, Beat; Toniolo, Martin; Bisig, Samuel Pascal; Tamborrini, Giorgio

doi:10.15557/jou.2015.0003

Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder 원문보기

Journal of ultrasonography, v.15 no.60 = no.60, 2015년, pp.29 - 44

Micheroli, Raphael (Department of Rheumatology, University Hospital of Basel, BaselSwitzerland) , Kyburz, Diego (Department of Rheumatology, University Hospital of Zurich, ZurichSwitzerland) , Ciurea, Adrian (Sonography Institute Glattpark, Zurich, Switzerland) , Dubs, Beat (Department of Rheumatology, University Hospital of Zurich, ZurichSwitzerland) , Toniolo, Martin (Swiss Federal Institute of Technology, Zurich, Switzerland) , Bisig, Samuel Pascal (Ultrasound Center, Department of Rheumatology, Bethesda Hospital Basel, BaselSwitzerland) , Tamborrini, Giorgio

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AbstractObjectiveHigh resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinical examination often does not allow an exact diagnosis. The aim of this study was to compare the fi ndings of clinical examination and high resolution ultrasonography in patients presenting with painful shoulder.MethodsNon-interventional observational study of 100 adult patients suffering from unilateral shoulder pain. Exclusion criteria were shoulder fractures, prior shoulder joint surgery and shoulder injections in the past month. The physicians performing the most common clinical shoulder examinations were blinded to the results of the high resolution ultrasonography and vice versa.ResultsIn order to detect pathology of the m. supraspinatus tendon, the Hawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas the Jobe supraspinatus test showed the highest specificity (0.55). To identify m. sub- scapularis tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas the belly press test showed the higher specificity (0.72). The infraspinatus test showed a high sensitivity (0.90) and specificity (0.74). All AC tests (painful arc IIa, AC joint tendernessb, cross body adduction stress testc) showed high specificities (a0.96, b0.99, c0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity (0.47) and the Yergason test the highest specificity (0.88).ConclusionKnowledge of sensitivity and specificity of various clinical tests is important for the interpretation of clinical examination test results. High resolution ultrasonography is needed in most cases to establish a clear diagnosis.

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참고문헌 (44)

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Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder 원문보기

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