Swimmer arm-to-shoulder test for early differentiation between shoulder and cervical spine pathology in patients with shoulder pain.

IF 2.2 3区医学 Q2 ORTHOPEDICS

BMC Musculoskeletal Disorders Pub Date : 2024-11-21 DOI:10.1186/s12891-024-08013-9

Hesham Hamoud, Hany Aly, Yasser A Elmotaleb, Mohamad M Ghit, Ahmad Mosalam, Tarek M Nasrallah, Saad M El Zokm, Ibrahim Fawzy, Abdelwahab N Bayoumy, Maha S Mohamed, Seham A Elazab, Amal M Elmesiry, Eman A Rageh, Mai A Moussa, Ahmed Elyasaki, Sherif Refaat, Ahmed M Elhilasy, Ahmed M El Deeb, Walid Elshaitany, Ashraf Eltabiey

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引用次数: 0

Abstract

Background: Several tests have been suggested for screening and diagnosis of cervical spine and shoulder girdle conditions underlying shoulder pain with variable degrees of clinical accuracy. The present study aimed to test the reliability, clinical benefit and screening value of the Swimmer Arm-to-Shoulder (SAS) test; a new clinical test developed to differentiate shoulder impingement from cervical radiculopathy in patients with shoulder pain of ≤ 12 weeks.

Methods: The study included 718 patients aged 40-65 years, with unilateral and localized shoulder girdle pain lasting for ≤ 12 weeks. Diagnosis based on clinical, electromyography and radiological findings was considered as the reference gold standard for test assessment.

Results: Clinical diagnosis identified shoulder pathology in 288 patients (40.1%) and cervical spine pathology in 430 patients (59.9%). SAS test was positive in 274 patients (38.2%). The SAS test proved to be effective in distinguishing shoulder from cervical spine pathology with a sensitivity of 89.2% (95% CI: 85.0-92.6%), specificity of 96.1% (95% CI: 93.8-97.7%), PPV of 93.8% (95% CI: 90.5-96.0%), NPV of 93.0% (95% CI: 90.5-94.9%), LR + of 22.6% (95% CI: 14.1-36.0%), LR- of 0.11 (95% CI: 0.08-0.16) and accuracy of 93.3% (95% CI: 91.2-95.0%).

Conclusions: SAS test is an easy to perform, patient dependent and reliable as a screening test and diagnosis confirmatory test.

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游泳者手臂对肩测试，用于早期区分肩痛患者的肩部和颈椎病变。

背景：有几种测试被建议用于筛查和诊断肩痛背后的颈椎和肩周疾病，但临床准确度不一。本研究旨在测试游泳者臂对肩（SAS）测试的可靠性、临床益处和筛查价值；SAS 是一项新开发的临床测试，用于区分肩痛时间不超过 12 周的肩关节撞击和颈椎病患者：研究对象包括 718 名年龄在 40-65 岁之间、单侧局部肩部疼痛持续时间不超过 12 周的患者。根据临床、肌电图和放射学检查结果进行诊断，作为检测评估的参考金标准：结果：288 名患者（40.1%）通过临床诊断发现肩部病变，430 名患者（59.9%）通过临床诊断发现颈椎病变。274名患者（38.2%）的SAS测试结果呈阳性。事实证明，SAS 检验能有效区分肩部和颈椎病变，其敏感性为 89.2%（95% CI：85.0-92.6%），特异性为 96.1%（95% CI：93.8-97.7%），PPV 为 93.8%（95% CI：90.5-96.0%），NPV：93.0%（95% CI：90.5-94.9%），LR+：22.6%（95% CI：14.1-36.0%），LR-：0.11（95% CI：0.08-0.16），准确率：93.3%（95% CI：91.2-95.0%）：SAS测试作为筛查测试和确诊测试，操作简便，依赖于患者，结果可靠。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Musculoskeletal Disorders 医学-风湿病学

CiteScore

3.80

自引率

8.70%

发文量

1017

审稿时长

3-6 weeks

期刊介绍： BMC Musculoskeletal Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of musculoskeletal disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The scope of the Journal covers research into rheumatic diseases where the primary focus relates specifically to a component(s) of the musculoskeletal system.