Physical and ultrasonic examination for evaluation of shoulder pain

Muhammed, Kharman Ramzi; AL Rawi, Ziad

doi:10.52573/ipmj.2024.137840

	Physical and ultrasonic examination for evaluation of shoulder pain
Iraqi Postgraduate Medical Journal
Volume 23, Issue 3, July 2024, Pages 338-344 PDF (253.16 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2024.137840
Authors
Kharman Ramzi Muhammed¹; Ziad AL Rawi^* ²
¹Student of Kurdistan Higher Council for Medical Specialties, Department of Rheumatology, Rizgary Teaching Hospital, Erbil – Iraq.
²medicine, college of medicine, University of Baghdad
Abstract
Background: Shoulder pain is one of the most common complaints encountered in Rheumatological practice and often leads to considerable disability. Aim of the study: to assess the diagnostic value of six clinical tests for identifying pathologies in patients complaining of shoulder pain, and utilize ultrasound examination (US) as an imaging modality to confirm the clinical diagnosis. Patients and Methods: This Cross-sectional study included 80 consecutive patients who presented with shoulder pain and at least one of the subsequent features: pain during daily activities, pain at night, neck pain, arm paresthesia, or numbness. Six clinical tests that elicit tenderness in the shoulder were performed and then ultrasonography was performed to confirm the diagnosis. Results: A total of 80 participants were enrolled in this study. Tenderness in various parts of the shoulder to deep palpation was the most accurate test for predicting the diagnosis with a sensitivity of 100% and specificity of 14.5%. There was a significant difference between shoulder pain in the dominant and non-dominant side (p-value <0.001), and significant differences between the clinical examination results and US findings for 5 tests, except for the drop-arm test which was insignificant (p = 1.000). There were no significant differences between diabetic and non-diabetic patients regarding all the shoulder ultrasound findings (p > 0.05). Conclusion: Although clinical tests are insufficient for diagnosis of the shoulder pathologies, the examination of the patient still plays an important role. However, Ultrasonography should be used for all patients suffering from a painful shoulder in order to confirm the diagnosis.
Keywords
Shoulder pain,,; ,،,؛diabetics,,; ,،,؛physical examination,,; ,،,؛US findings

References
Lasbleiz S, Quintero N, Ea K, et al. Diagnostic value of clinical tests for degenerative rotator cuff disease in medical practice. Ann Phys Rehabil Med. 2014;57:228-43. Ottenheijm RP, van’t Klooster IG, Starmans LM, et al. Ultrasound-diagnosed disorders in shoulder patients in daily general practice: a retrospective observational study. BMC family practice 2014;15: 1-6.‏ Ottenheijm Rp, Jansen M. J, Staal JB, et al. Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation 2010;91:1616-25. Alqunaee M, Galvin R, Fahey T, et al. Diagnostic accuracy of clinical tests for subacromial impingement syndrome: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2012;93:229-36. Bloom A, Warwick D, Mapton S, et al. Apley & Solomon's System of Orthopaedics and Trauma. 10thed. Taylor and Francis group 2018;351-81. Van Riet RP, Bell SN, et al. Clinical evaluation of acromioclavicular joint pathology: sensitivity of a new test. J Shoulder Elbow Surg. 2011;20:73-76. Jiang L, He J, Chen CP, et al. The Ultrasonographic Features of Shoulder Pain Patients in a Tertiary Hospital in South China. BioMed Research International. 2020;(1):3024793. Yazigi Junior JA, Nicolao FA, Matsunaga, FT, et al. Sensitivity and specificity of ultrasonography in diagnosing supraspinatus lesions: a prospective accuracy diagnostic study. Sao Paulo Medical Journal 2018;136: 292-97. Wang JC, Chang KV, Wu WT, et al. Ultrasound-guided standard vs dual-target subacromial corticosteroid injections for shoulder impingement syndrome: a randomized controlled trial. Archives of physical medicine and rehabilitation 2019; 100:2119-28. Çağlar Okur S, Çirçi E, et al. Ultrasonographic Evaluation of Shoulder in Patients with Diabetes Mellitus. Bezmialem Science 2019;7:8-11. Kandil N M.M, ELSHEWI I E , ABBAS H M,et al. A Case Control Study of Ultrasound Evaluation of shoulder Joint among Diabetic and Non-Diabetic Patients. The Medical Journal of Cairo University, 2022; 90:1267-77. Madurwar AU, Sravan Kumar K, Ramya, Bhavani A, et al. Clinico-radiological correlation of shoulder joint pain. IJSR 2017; 6:1117-22. Keener JD, Steger-May K, Stobbs G, Yamaguchi K, et al. Asymptomatic rotator cuff tears: patient demographics and baseline shoulder function. J Shoulder Elbow Surg 2010;19:1191-98. Khan M S Z, Rahman N, Ferdousi M A, et al. Ultrasonographic findings in patients with shoulder pain. BIRDEM Medical Journal 2019;9:218–22. Patidar M, Patil A, Verma V, & Kaushal L, et al. Evaluation of Painful Shoulder with High Frequency Sonography and their Comparison with the Clinical Diagnosis made by Physical Examination. Nepalese Journal of Radiology 2012;2: 43–50. Kumar Reddy KV, Babu LMM, Suresh A, et al. CLINOCO-RADIOLOGICAL CORRELATION OF SHOULDER pain. European Journal of molecular & Clinical Medicine. 2022;9:60-69. Kang JH, Tseng SH, Jaw FS, et al. Comparison of ultrasonographic findings of the rotator cuff between diabetic and nondiabetic patients with chronic shoulder pain: a retrospective study. Ultrasound Med Biol. 2010;36:1792-96.
Statistics Article View: 354 PDF Download: 107