Abstract
In this study, we aimed to investigate the prevalence of SLAP lesions in patients with chronic impingement syndrome. We also examined the sensitivity of O'Brien's test. The study included 48 patients with a preliminary chronic impingement syndrome diagnosis to whom arthroscopic decompression had been planned. All patients underwent preoperative Neer's, Hawkins' and O'Brien's tests. We performed shoulder arthroscopy on all patients and evaluated chronic impingement syndrome and SLAP lesions. Then, we compared the statistical sensitivities of these tests. The mean age of patients with chronic impingement was 45.8 years (range, 35-69 years). O'brien's test was positive in 34 (70.8%) of the patients, and Neer's test and Hawkins' test were positive in 46 (95.8%) of the patients before shoulder arthroscopy. Shoulder arthroscopy revealed that 44 (91.7%) of 48 patients had subacromial impingement; 32 (66.7%) had SLAP lesions and internal impingement. In chronic impingement syndrome, sensitivity rates were 95.6% for Neer's test and Hawkins' test, whereas in internal impingement syndrome and slap lesions, the sensitivity of O'brien's test was 94.1%. There was no statistical difference between the tests (p>0.05). 72.72% of the patients with chronic impingement syndrome had concomitant SLAP lesions. We suggest that O'Brien's test should be used with Neer's and Hawkins' tests for diagnosis of this condition.
Highlights
One of the common causes of shoulder pain is chronic impingement syndrome [1,2,3,4], which results from compression of the rotator cuff mechanism in between the acromion, coracoacromial ligament, coracoid process and acromioclavicular joint during movements of the glenohumeral joint, especially during flexion and external rotation [5,6,7,8].Chronic impingement syndrome should be evaluated for external and internal impingement [9, 10]
We suggest that O’Brien’s test should be used with Neer’s and Hawkins’ tests for diagnosis of this condition
Yildiz et al SLAP Lesion and the Sensitivity of O’Brien’s Test physical examination should be performed, and differential diagnoses should be kept in mind
Summary
One of the common causes of shoulder pain is chronic impingement syndrome [1,2,3,4], which results from compression of the rotator cuff mechanism in between the acromion, coracoacromial ligament, coracoid process and acromioclavicular joint during movements of the glenohumeral joint, especially during flexion and external rotation [5,6,7,8].Chronic impingement syndrome should be evaluated for external and internal impingement [9, 10]. Yildiz et al SLAP Lesion and the Sensitivity of O’Brien’s Test physical examination should be performed, and differential diagnoses should be kept in mind. Neer’s and Hawkins’ tests are known as the most specific tests for diagnosis [11]. O’Brien’s test is an effective test for labral abnormalities and is sensitive and specific for acromioclavicular joint abnormalities [12]. We investigated the frequency of SLAP lesions in patients with chronic impingement syndrome, and we aimed to compare the sensitivity of O’Brien’s test to that of Neer’s and Hawkins’ tests. We conducted this study to show that performing O’Brien’s test together with Neer’s and Hawkins’ tests for the diagnosis of subacromial impingement is important because of the high frequency of SLAP lesions in patients with chronic impingement syndrome
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