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Education review
Education from other journals #12
  1. Darren Patrick Moloney1,
  2. Ronan Kearney2,3,
  3. Matthew Cosgrave4,
  4. Christina Le5
  1. 1 Orthopaedics, Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2 Department of General Practice, Irish College of General Practitioners, Dublin, Ireland
  3. 3 Faculty of Sports and Exercise Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  4. 4 Department of General Practice, Royal College of General Practitioners, Belfast, UK
  5. 5 Glen Sather Sports Medicine Clinic, Edmonton, Alberta, Canada
  1. Correspondence to Dr Ronan Kearney, Royal College of Surgeons in Ireland, Dublin 2, Ireland; ronankearney{at}rcsi.ie

https://doi.org/10.1136/bjsports-2018-100283

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    Does my patient with shoulder pain have a rotator cuff tear? A predictive model from the ROW cohort

    Orthop J Sports Med 2018 ;6:2325967118784897

    Rotator cuff disorders are the most common cause of shoulder pain in the general population. Unfortunately, the diagnosis of a rotator cuff tear is not always obvious and can present a diagnostic dilemma, especially in the older patients. When uncertainty exists, expensive imaging such as MRI may be required to aid diagnosis.

    When it comes to the clinical examination of a shoulder, there are an abundance of ‘special tests’, although individually these tests are limited in diagnostic accuracy for rotator cuff tears. Would not it be great if a battery of clinical tests could predict the likelihood of a tear? Such a tool would be convenient for the primary care physician whose access to ultrasound or MRI is often limited and costly.

    In this analysis of 301 patients, four diagnostic variables: male sex, Jobe’s test (empty can test), lift-off test and external rotation strength ratio were highly predictive of a rotator cuff tear in patients ≥45 years of age with >4 weeks of shoulder pain.

    Take home message: This diagnostic aid has the potential to improve clinical identification of rotator …

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    Footnotes

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.

    • Collaborators Education from other journals BJSM team.