Positive Coracoid Pain Test - A clinical Sign of Adhesive Capsulitis of Shoulder – an observational study
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
Back ground: Though pain in and around shoulder joint is one of the commonest presenting complaints by the patients attending physiatric OPD, which may be due to various causes and Adhesive capsulitis being one among them, till date there is no specific clinical test/sign characteristic of Adhesive Capsulitis. Objective: The primary objective of this study was to validate Coracoid pain test (CPT), proposed by S Carbone et al, as a pathognomonic sign of Adhesive Capsulitis in our set up. The secondary objectives were to study the associated factors like age, sex, laterality, diabetes, occupation and history of injury. Materials & methods: The study group included 49 consecutive patients (27 males & 22 females with age groups varying from 21 to 75 years) attending physiatric OPD in a tertiary care centre (Government Institute of Rehabilitation Medicine, Madras Medical college, Chennai) with presenting complaint of pain in and around shoulder joint including neck pain radiating to arm, 29 with Adhesive capsulitis(Ad Cap), 12 with Cervical Brachialgia(CB), 5 with Supraspinatus tendinosis(SST), 3 with Acromio clavicular joint disruption(ACJD) and 49 age and sex matched asymptomatic subjects as controls. Visual Analogue Scale (VAS) was used to assess the severity of pain. The test was considered positive when pain on pressure over coracoid area is more severe than over Acromio Clavicular joint and Sub Acromial area(>/=3points in VAS). Results: The test was positive in 79.31%(Ad Cap), 91.66%(CB), 20%(SST), 66.66%(ACJD) of patients with mentioned four conditions with mean VAS score of 5.10, 6.25, 2 and 5.33 respectively, and also positive in 14.81% and 54.55% of male and females of control group respectively. And Positive CPT is statistically significant (99%) with p value <0.01 among patients with Ad Cap, CB and females of control group. Conclusion: With the sample size limitations, our study suggests positive Coracoid Pain Test may not be a pathognomonic sign of Adhesive Capsulitis shoulder. In other words, positive CPT could be one more additional clinical test to suggest a diagnosis of Adhesive Capsulitis. CPT instead was more correlated to Cervical Brachialgia though it was nonspecific. However, a double blinded large scale controlled study is required to prove it.
Authors and Affiliations
Thirunavukkarasu P, Geetha Kalpana J, Jayakumar T, Ramesh C, Padmapriya P
Keywords
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