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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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