Clinical diagnostics of the shoulder’s soft tissue injures

Abstract

Annotation. Our study is based on data of 444 patients with clinically, MRI diagnosed and then arthroscopically proved diagnosis of the shoulder’s soft tissue injures. Used the following diagnostic tests: “typical pain localization”, shoulder blade rhythm disturbance, “apprehension”, front driver test, compression rotary test, rear driver test, impedance test Nir, Hawkins, weaknesses of withdrawal, weakness of external rotation, “lift off”, “belly press”, “false paralysis”. We have described the most informative and simple clinical tests. Sensitivity and specificity for each clinical test were calculated. Sensitivity and specificity of these tests are statistically adjusted. It has been found that for clinical diagnostics of damage to the anterior-lower lip of the shoulder joint is more diagnostically attractive is the anterior driver test; for diagnosis of damage to the upper lip of the shoulder joint — compression-rotation test, preference is given to the rear “driver test”; for the diagnosis of subacromial conflict syndrome — a combination of two tests: Hawkins test and impingement test; for diagnosis of lesions of the supraspinatus muscle — test of weakness of the abduction; underarm muscle — test of weakness of external rotation; for the diagnosis of total damage to the rotator cuff (RС) — test “falling” hand; the specificity of “belly press” test is higher than the specificity of “Lift off” test when it is impossible to get your hand behind your back. Thus, tests of characteristic localization of pain and disturbance of the shoulder bladder rhythm are sufficient to suspect the patient of the pathology of the shoulder joint complex itself.