A sono-clinical study: Is probe palpation better than a cross arm test for detecting acromio-clavicular joint pathology in chronic painful shoulder?
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 5
Abstract
Objective: This prospective study was undertaken to determine whether palpation is more informative then cross arm test in diagnosing chronic acromio-clavicular joint pain (ACJ). This study used high resolution ultrasonography (HRU) as gold standard to confirm the findings of clinical examinations in patients presenting with chronic painful shoulder of multiple etiology. Methods: It is a non-interventional prospective observational study. The physicians performing the clinical shoulder examinations and those performing sono imaging were blinded to the results each made. Results: There were 73 patients, 35 males and 38 females whose mean age was 47.6 ± 11.51 years (range 22-80 years). Of them 36 patient had AC joint affection. Cross-arm test (CAT) showed sensitivity of 86.1 %, specificity of 91.9 %, positive predictive values of 91.9%,negative predictive value 87.2 %, positive likelihood ratio 10.63, negative likelihood ratio 0.15, Cohen’s κ coefficient 0.781. Probe palpation tenderness showed sensitivity of 100 %, specificity of 67.6 %, positive predictive values 75 %, negative predictive value 100 %, positive likelihood ratio 3.09, negative likelihood ratio 0, Cohen’s κ coefficient 0.673. Both the CAT and Probe tenderness showed strong correlation with a Pearson coefficient of 0.782 and 0.712. Conclusion: Cross arm Test is the most rational singular choice of test to be performed with confidence and it has better validity than probe palpation in diagnosing chronic painfully restricted shoulder with acromio-clavicular joint pathology.
Authors and Affiliations
Dr Kshetra Madhab Das, MBBS,M. D. (PM&R)
Keywords
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