Clinical evaluation of acromioclavicular joint pathology: Sensitivity of a new test

Background A prospective study was established to assess the sensitivity of the newly described Bell-van Riet (BvR) test for isolated AC pathology, and compare with 4 commonly used clinical tests. Materials and methods The BvR test is essentially the cross-adduction test, with the addition of attemp...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2011, Vol.20 (1), p.73-76
Main Authors: van Riet, Roger P., MD, PhD, Bell, Simon N., FRACS (Orth), PhD
Format: Article
Language:English
Subjects:
AC joint
acromioclavicular
Acromioclavicular Joint
Adult
Aged
Aged, 80 and over
arthritis
Biological and medical sciences
clinical test
Diseases of the osteoarticular system
Female
Humans
Joint Diseases - diagnosis
Male
Medical sciences
Middle Aged
Orthopedics
Physical Examination
Sensitivity and Specificity
Shoulder
Shoulder Pain - etiology
Young Adult
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Summary:Background A prospective study was established to assess the sensitivity of the newly described Bell-van Riet (BvR) test for isolated AC pathology, and compare with 4 commonly used clinical tests. Materials and methods The BvR test is essentially the cross-adduction test, with the addition of attempted elevation against resistance. In a positive test, this results in some pain and the inability of the patient to maintain the arm in the adducted and elevated position against resistance. Fifty-eight patients with isolated AC joint symptoms were assessed in random order with the BvR test and 4 other tests. A corticosteroid and local anaesthetic injection was administered into the AC joint space. The BvR test and 4 other tests were then repeated following the injection. After the injection, a symptom free clinical examination was used as a measure of truly positive tests. Results The BvR test showed a sensitivity of 98%. All 4 other tests were less sensitive. Conclusion The BvR test is a highly sensitive test in patients presenting with isolated AC related symptoms, and demonstrates AC joint pathology better than other accepted tests.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2010.05.023