Palpation tests versus impingement tests in Neer stage I and II subacromial impingement syndrome

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2013-02, Vol.21 (2), p.424-429
• Main Authors: Toprak, Ugur, Ustuner, Evren, Ozer, Derya, Uyanık, Sadık, Baltacı, Gul, Sakızlıoglu, Secil Sezgin, Karademir, Mehmet Alp, Atay, Ahmet Ozgur
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Arthritis; Evaluation; Female; Humans; Male; Medical examinations; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Pain; Patients; Physical Examination - methods; Radiology; Range of motion; Rotator cuff; Rotator Cuff - diagnostic imaging; Shoulder; Shoulder Impingement Syndrome - diagnosis; Shoulder Impingement Syndrome - diagnostic imaging; Shoulders; Specificity; Sports; Surgery; Tendons; Ultrasonic imaging; Ultrasonography
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-012-1969-7

Purpose Using sonographic findings to test the diagnostic accuracy of impingement versus tendon palpation tests in Neer stage I and II subacromial impingement syndrome cases and examine their clinical potential. Methods Neer and Hawkins impingement tests and rotator cuff tendon palpation tests followed by bilateral shoulder sonography were conducted on 69 patients with a clinical diagnosis of unilateral subacromial impingement. Results The Neer and Hawkins tests had 74 and 62 % accuracy (sensitivity 80 and 67 %, and specificity 52 and 47 %, respectively) in comparison to 79 and 62 % accuracy rates for supraspinatus and biceps tendon palpation tests (sensitivity 92 and 41 %, and specificity 41 and 48 %, respectively). Overall, the palpation tests scored better than impingement tests in the diagnosis of Neer stage I and II subacromial impingement syndrome. No tendinosis or tear was noted in patients with negative findings in the supraspinatus palpation tests (sensitivity 100 %, specificity 21 %). Conclusion Palpation tests for supraspinatus and biceps tendons have a slightly higher accuracy than the impingement tests, and if tenderness does not exist then supraspinatus tendinopathy can be ruled out. These findings warrant the use of palpation tests in a routine physical examination for tendinopathy. Level of evidence I.