Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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What are Valuable Positive Signs of Supraspinatus Test for Diagnosis of Torn Rotator Cuff? - Comparison of Pain and Weakness in "Empty Can Test" and "Full Can Test" -

회전근 개 파열의 진단을 위한 극상근 검사에서 유용한 양성 징후는 무엇인가? - "Empty can test"와 full can test"에서 통증과 근력 약화의 비교 -

  • Shin, Hun-Kyu (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Eu-Gene (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jeong, Hwa-Jae (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong-Min (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Choi, Jae-Yol (Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Lee, Yong-Taek (Department of Rehabilitation, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 신헌규 (성균관대학교 의과대학 강북삼성병원 정형외과) ;
  • 김유진 (성균관대학교 의과대학 강북삼성병원 정형외과) ;
  • 정화재 (성균관대학교 의과대학 강북삼성병원 정형외과) ;
  • 김종민 (성균관대학교 의과대학 강북삼성병원 정형외과) ;
  • 최재열 (성균관대학교 의과대학 강북삼성병원 정형외과) ;
  • 이용택 (성균관대학교 의과대학 강북삼성병원 재활의학과)
  • Published : 2007.06.15
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Abstract

Purpose: To investigate the validity of positive signs of supraspinatus test. Materials and Methods: The empty can test and full can test were performed on 200 shoulders which were diagnosed with magnetic resonance imaging or surgical findings as full thickness tear, partial thickness tear and no tear. Presence of pain, weakness, pain or weakness, and both pain and weakness were recorded as positive signs separately. The two tests with positive signs were compared and analyzed. Results: Pain and weakness were severity-dependent, and the empty-can test had a higher incidence of pain. The sensitivities of the two supraspinatus tests in all positive signs were higher when including partial-thickness tears in the tear group; however, their specificities were higher when excluding partial-thickness tears. The sensitivities of an empty-can test in 'pain', 'pain or weakness', 'both pain and weakness' were higher than those of the full-can test, otherwise, the specificity of the full-can test for 'pain' and 'pain or weakness' were higher. Concordance rate between 'pain or weakness' and 'pain' was the highest in all categorization. Conclusion: Both empty can and full can test were valuable for detecting torn rotator cuff.

목적: 회전근개 파열에서 극상근 검사의 진단적 가치와 유용한 검사 양성이 무엇인지를 밝히고자 하였다. 대상 및 방법: 견관절 통증 환자 200명을 대상으로 empty can test와 full can test를 시행하여 수술 또는 자기공명영상의 소견으로 분석하였다. 통증과 근력 약화를 나누어 기록하였으며, 파열의 정도에 따른 통증과 근력약화의 분포, 각 검사법의 예측율 및 기존의 양성이라고 정의 되었던 통증 또는 근력약화가 있는 경우와 다른 양성 징후 들과의 조합에 대한 일치도를 조사하였다. 결과: 통증과 근력약화는 회전근개 파열의 정도에 따라 비례하였고 empty can test에서 통증의 빈도가 높았다. 부분파열을 파열로 간주한 경우 두 검사 모두 민감도가 높았으나 특이도는 전층 열만을 파열로 간주한 경우가 높았다. 부분파열을 파열로 간주한 경우와 그렇지 않은 경우, 또한 Empty 및 Full can test 모두에서 통증과의 일치도가 가장 높았다. 결론: empty can test가 통증의 빈도가 높았으며, 두 가지 극상근 검사 모두 전층파열과 부분파열에 민감하고 전층파열에 특이하였다. 극상근 검사는 통증과 근력 약화를 분리하여 양성을 기록한다면 회전근 개 파열의 진단을 위한 이학적 검사로서 가치가 높다고 판단되었다.

Keywords

References

  1. Ben-Yishay A, Zuckerman JD, Gallagher M, Cuomo F: Pain inhibition of shoulder strength in patients with impingement syndrome. Orthopedics, 17: 685-688, 1994.
  2. Deutsch A, Altchek DW, Veltri DM, Potter HG, Warren RF: Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment. Am J Sports Med, 25: 13-22, 1997. https://doi.org/10.1177/036354659702500104
  3. Greis PE, Kuhn JE, Schultheis J, Hintermeister R, Hawkins R: Validation of the lift-off test and analysis of subscapularis activity during maximal internal rotation. Am J Sports Med, 24: 589-593, 1996. https://doi.org/10.1177/036354659602400505
  4. Gschwend N, Ivosevic-Radovanovic D, Patte D: Rotator cuff tear-relationship between clinical and anatomopathological findings. Arch Orthop Trauma Surg, 107: 7-15, 1988.
  5. Hertel R, Ballmer FT, Lombert SM, Gerber C: Lag signs in the diagnosis of rotator cuff rupture. J Shoulder Elbow Surg, 5: 307-313, 1996. https://doi.org/10.1016/S1058-2746(96)80058-9
  6. Holtby R, Razmjou H: Validity of the supraspinatus test as a single clinical test in diagnosing patients with rotator cuff pathology. J Orthop Sports Phys Ther, 34: 194-200, 2004. https://doi.org/10.2519/jospt.2004.34.4.194
  7. Iannotti JP, Zlatkin MB, Esterhai JL, Kressel HY, Dalinka MK, Spindler KP: Magnetic resonance imaging of the shoulder. Sensitivity, specificity, and predictive value. J Bone Joint Surg Am, 73: 17-29, 1991.
  8. Itoi E, Kido T, Sano A, Urayama M, Sato K: Which is more useful, the "full can test" or the "empty can test", in detecting the torn supraspinatus tendon? Am J Sports Med, 27: 65-68, 1999.
  9. Jobe FW, Moynes DR: Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med, 10: 336-339, 1982. https://doi.org/10.1177/036354658201000602
  10. Kelly BT, Kadrmas WR, Speer KP: The manual muscle examination for rotator cuff strength. An electromyographic investigation. Am J Sports Med, 24: 581-588. 1996. https://doi.org/10.1177/036354659602400504
  11. Lee YS, Kim JY, Cho DY, Kim YH, Kim SH: Diagnostic Accuracy of Physical Examinations in Impingement Syndrome and Rotator Cuff Tear. J Korean Shoulder Elbow Soc, 4: 186-190, 2001.
  12. Leroux JL, Thomas E, Bonnel F, Blotman F: Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum Engl Ed. 62: 423-428, 1995.
  13. Lyons AR, Tomlinson JE: Clinical diagnosis of tears of the rotator cuff. J Bone Joint Surg Br, 74: 414-415, 1992.
  14. Moon YL, You JW, Kim DH: Empty can test for diagnosis of supraspinatus tear. J Korean Shoulder Elbow Soc, 4: 13-416, 2001.
  15. Ure BM, Tiling T, Kirchner R, Rixen D: Reliability of clinical examination of the shoulder in comparison with arthroscopy. A prospective study. Unfallchirurg, 96: 382-386, 1993.