Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 8/2017

22.05.2017 | Original Article • SHOULDER - INPINGEMENT

The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome

verfasst von: Yu Guosheng, Ren Chongxi, Cui Guoqing, Xu Junling, Ji Hailong

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Subacromial impingement syndrome (SAIS) is characterized by pain experienced through an arc of elevation as the shoulder abducts and diagnosed commonly by Neer test (NT). However, the diagnostic accuracy of NT for SAIS is still limited. Here, a modified Neer test (MNT) was introduced to improve the accuracy of the clinical examination in diagnosing SAIS and differentiating it from frozen shoulder. The aim of this study was to investigate the diagnostic values of MNT in diagnosing SAIS and differentiating it from frozen shoulder.

Methods

Between January 2015 and June 2015, a prospective study assessed 85 shoulders among 82 patients with shoulder joint disease; 42 patients underwent arthroscopic surgery, and all 82 patients received X-rays, magnetic resonance imaging (MRI) or MRI contrast examinations. The diagnostic criteria are based on arthroscopy and MRI scanning.

Results

Using clinical epidemiology and diagnostic tests, we calculated the sensitivity, specificity, positive predictive value, negative predictive value and degree of accuracy of MNT in diagnosing SAIS. The diagnostic accuracy rate of MNT in identifying shoulder SAIS was 90.59%, and the specificity was 95.56%.

Conclusions

In the diagnosis of SAIS, MNT is a reliable and highly accurate maneuver and seems useful to distinguish this syndrome from frozen shoulder.
Literatur
1.
Zurück zum Zitat Bhattacharyya R, Edwards K, Wallace AW (2014) Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study. BMC Musculoskelet Disord 29(15):324. doi:10.1186/1471-2474-15-324 CrossRef Bhattacharyya R, Edwards K, Wallace AW (2014) Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study. BMC Musculoskelet Disord 29(15):324. doi:10.​1186/​1471-2474-15-324 CrossRef
2.
Zurück zum Zitat Umer M, Qadir I, Azam M (2012) Subacromial impingement syndrome. Orthop Rev (Pavia) 4(2):e18CrossRef Umer M, Qadir I, Azam M (2012) Subacromial impingement syndrome. Orthop Rev (Pavia) 4(2):e18CrossRef
3.
Zurück zum Zitat Harrison AK, Flatow EL (2011) Subacromial impingement syndrome. J Am Acad Orthop Surg 19(11):701–708CrossRefPubMed Harrison AK, Flatow EL (2011) Subacromial impingement syndrome. J Am Acad Orthop Surg 19(11):701–708CrossRefPubMed
4.
Zurück zum Zitat Neer CS II (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54(1):41–50CrossRefPubMed Neer CS II (1972) Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 54(1):41–50CrossRefPubMed
5.
Zurück zum Zitat Buchherger DJ (1999) Introduction of a new physical examination procedure for the differentiation of acromioclavicular joint lesions and subacromial impingement. J Manip Physiol Ther 22:316–321CrossRef Buchherger DJ (1999) Introduction of a new physical examination procedure for the differentiation of acromioclavicular joint lesions and subacromial impingement. J Manip Physiol Ther 22:316–321CrossRef
6.
Zurück zum Zitat Herlel R, Ballmer FT, Lomherl SM et al (1996) Lag signs in the diagnosis of rotator cull rupture. J Shoulder Elhow Surg 5:307–313CrossRef Herlel R, Ballmer FT, Lomherl SM et al (1996) Lag signs in the diagnosis of rotator cull rupture. J Shoulder Elhow Surg 5:307–313CrossRef
7.
Zurück zum Zitat Watch G, Boulahia A, Calderone S et al (1998) The ‘dropping’ and ‘hornblower’s’ signs in evaluation of rotator-cuff tears. J Bone Joint Surg (Br) 80:624–628CrossRef Watch G, Boulahia A, Calderone S et al (1998) The ‘dropping’ and ‘hornblower’s’ signs in evaluation of rotator-cuff tears. J Bone Joint Surg (Br) 80:624–628CrossRef
8.
Zurück zum Zitat Iloi E, Kido T, Sano A et al (1999) Which is more useful, the “full can test” or the “empty can test,” in detecting the torn supraspinatus tendon? Am J Sports Med 27(1):65–68CrossRef Iloi E, Kido T, Sano A et al (1999) Which is more useful, the “full can test” or the “empty can test,” in detecting the torn supraspinatus tendon? Am J Sports Med 27(1):65–68CrossRef
9.
Zurück zum Zitat Hannafin JA, Chiaia TA (2000) Adhesive capsulitis: a treatment approach. Clin Orthop Relat Res 372:95–109CrossRef Hannafin JA, Chiaia TA (2000) Adhesive capsulitis: a treatment approach. Clin Orthop Relat Res 372:95–109CrossRef
10.
Zurück zum Zitat Connell D, Padmanabhan R, Buchbinder R (2002) Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol 12:2100–2106 (Epub 2002 Mar 7) CrossRefPubMed Connell D, Padmanabhan R, Buchbinder R (2002) Adhesive capsulitis: role of MR imaging in differential diagnosis. Eur Radiol 12:2100–2106 (Epub 2002 Mar 7) CrossRefPubMed
11.
Zurück zum Zitat Hegedus EJ, Goode A, Campbell S et al (2008) Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. Br J Sports Med 42(2):80–92 (discussion 92. Epub 2007 Aug 24) CrossRefPubMed Hegedus EJ, Goode A, Campbell S et al (2008) Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. Br J Sports Med 42(2):80–92 (discussion 92. Epub 2007 Aug 24) CrossRefPubMed
13.
Zurück zum Zitat Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG (2005) Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 87(7):1446–1455PubMed Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG (2005) Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 87(7):1446–1455PubMed
14.
Zurück zum Zitat Hegedus EJ, Goode AP, Cook CE et al (2012) Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med 46(14):964–978. doi:10.1136/bjsports-2012-091066 (Epub 2012 Jul 7) CrossRefPubMed Hegedus EJ, Goode AP, Cook CE et al (2012) Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med 46(14):964–978. doi:10.​1136/​bjsports-2012-091066 (Epub 2012 Jul 7) CrossRefPubMed
15.
Zurück zum Zitat Guoqing C, Yingfang A, Changlong Y et al (2000) A clinical analysis of 38 cases subacromial impingement syndrome. Chin J Orthop 20:467–469 Guoqing C, Yingfang A, Changlong Y et al (2000) A clinical analysis of 38 cases subacromial impingement syndrome. Chin J Orthop 20:467–469
16.
Zurück zum Zitat Neer CS II (1983) Impingement Lesions. Clin Orthop Relat Res 173:70–77 Neer CS II (1983) Impingement Lesions. Clin Orthop Relat Res 173:70–77
18.
Zurück zum Zitat Pal B, Anderson J, Dick WC et al (1986) Limitation of joint mobility and shoulder capsulitis in insulin and noninsulin dependent diabetes mellitus. Br J Rheumatol 25(2):147CrossRefPubMed Pal B, Anderson J, Dick WC et al (1986) Limitation of joint mobility and shoulder capsulitis in insulin and noninsulin dependent diabetes mellitus. Br J Rheumatol 25(2):147CrossRefPubMed
19.
Zurück zum Zitat Bunker TD, Anthony PP (1995) The pathology of Limitation of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 77(5):677PubMed Bunker TD, Anthony PP (1995) The pathology of Limitation of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br 77(5):677PubMed
21.
Zurück zum Zitat Lee SY, Park J, Song SW (2012) Correlation of MR arthrographic findings and range of shoulder motions in patients with frozen shoulder. Am J Roentgenol 198(1):173–179. doi:10.2214/AJR.10.6173 CrossRef Lee SY, Park J, Song SW (2012) Correlation of MR arthrographic findings and range of shoulder motions in patients with frozen shoulder. Am J Roentgenol 198(1):173–179. doi:10.​2214/​AJR.​10.​6173 CrossRef
Metadaten
Titel
The diagnostic value of a modified Neer test in identifying subacromial impingement syndrome
verfasst von
Yu Guosheng
Ren Chongxi
Cui Guoqing
Xu Junling
Ji Hailong
Publikationsdatum
22.05.2017
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 8/2017
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-017-1979-8

Weitere Artikel der Ausgabe 8/2017

European Journal of Orthopaedic Surgery & Traumatology 8/2017 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.