A Study to Find the Correlation Between Clinical and Ultrasonographic Findings in the Patients Presented with Painful Shoulder Conditions – A Hospital-Based Prospective Study
Background: Shoulder pain is the third most common musculoskeletal complaint and may be associated with impairments and marked disabilities. Precise diagnosis is essential prior to initiating any treatment. While clinical examination may not always yield accurate results, radiological investigations...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Medical Journal of Dr. D.Y. Patil Vidyapeeth |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_371_24 |
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| Summary: | Background:
Shoulder pain is the third most common musculoskeletal complaint and may be associated with impairments and marked disabilities. Precise diagnosis is essential prior to initiating any treatment. While clinical examination may not always yield accurate results, radiological investigations are imperative for improved management. Ultrasonography is a highly specific and sensitive modality. The aim of this study was to correlate clinical examination findings with ultrasonographic findings in painful shoulder conditions and to study the role of ultrasound in the diagnosis of various painful shoulder conditions.
Methods:
A hospital-based prospective study was conducted among 154 patients with complaints of shoulder pain. Clinical examinations using various special tests were performed, and the findings were compared with those of high-resolution ultrasonography (HRUSG).
Results:
The mean age of participants was 47.69 years, with the majority aged 50–60 years (27.9%). Female participants comprised 50.6% of the study cohort. For detecting partial thickness supraspinatus tears, the Empty Can and Drop Arm tests demonstrated similar sensitivities of 69.57% (95% CI: 52.12% to 82.84%), with the Drop Arm test showing higher specificity at 85.50% (95% CI: 75.98% to 92.38%). The Lift Off test had a sensitivity of 28.57% (95% CI: 5.32% to 71.84%) and a specificity of 85.71% (95% CI: 75.32% to 92.71%) for partial thickness subscapularis tears. For full thickness supraspinatus tears, both Empty Can and Drop Arm tests had a sensitivity of 85.71% (95% CI: 63.99% to 97.60%), but the Drop Arm test was more specific at 80.27% (95% CI: 66.10% to 90.59%). Clinical tests were ineffective in identifying rotator cuff tendinosis and effusion. Both Speed and Yergason tests had 50% sensitivity (95% CI: 24.68% to 75.32%) for partial biceps tendon tears, with Yergason test showing better specificity at 90.13% (95% CI: 75.47% to 97.13%). For biceps tendinosis, both tests had poor sensitivity, but Yergason test had better specificity at 90.54% (95% CI: 77.64% to 97.33%).
Conclusion:
HRUSG significantly complements clinical examination data, enhancing the diagnosis of painful shoulder conditions. Clinical tests alone showed limited diagnostic accuracy, underscoring the need for ultrasonographic assessment. |
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| ISSN: | 2589-8302 2589-8310 |