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Education from other journals #12
  1. Darren Patrick Moloney1,
  2. Ronan Kearney2,3,
  3. Matthew Cosgrave4,
  4. Christina Le5
  1. 1Orthopaedics, Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2Department of General Practice, Irish College of General Practitioners, Dublin, Ireland
  3. 3Faculty of Sports and Exercise Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  4. 4Department of General Practice, Royal College of General Practitioners, Belfast, UK
  5. 5Glen 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

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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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