THU0487 DIAGNOSTIC DILEMMA: WHICH CLINICAL TEST IS MOST ACCURATE FOR DIAGNOSING SUPRASPINATUS MUSCLE TEARS AND TENDINOSIS?

Abstract

Background:Supraspinatus tears and tendinosis are the most common pathology that cause shoulder pain to approximately half of the patients presenting clinically.1Objectives:To investigate the diagnostic accuracy of five clinical tests in the diagnosis of supraspinatus tears and tendinosis compared with magnetic resonance imaging (MRI).Methods:A total of 116 painful shoulders of 106 consecutive patients were examined. Patients were assessed using the most commonly used special clinical tests including the Jobe test (empty can), Neer test, drop arm test, Hawkins test and full can tests to identify supraspinatus tears and tendinosis. A visual analogue scale (VAS) was used for pain detection, and the Shoulder Pain and Disability Index (SPADI) questionnaire was administered. MRI examinations were performed on 1.5 Tesla MR system and images were assessed by a blinded radiologist. The primary outcomes were to determine the sensitivity, specificity, and accuracy of the five clinical tests, and to establish their correlation with MRI for supraspinatus tears and tendinosis.Results:The mean age was 55.10 ± 10.20 years, and 32.08% of the patients were female. The Hawkins test had a higher sensitivity and accuracy in tears (sensitivity 89.66%, accuracy 56.03%, respectively) and higher sensitivity in tendinosis (79.07%). The drop arm test had a lower sensitivity but higher specificity in both tendinosis and tears (sensitivity 0%, 12.07%, respectively, and specificity 87.67%, 96.5%, respectivelyConclusion:The Hawkins test was the most sensitive in both supraspinatus tendinosis and tears compared with MRI findings.