Rotator cuff crepitus: could Codman really feel a cuff tear?

Ponce, Brent A.; Kundukulam, Joseph; Sheppard, Evan; Determann, Jason R.; McGwin, Gerald; Narducci, Carl A.; Crowther, Marshall

doi:10.1016/j.jse.2013.12.037

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…Thirdly, we did not include the transdeltoid palpation test for comparison in the study because its diagnostic value for all types of supraspinatus tears was reported to be limited and because it requires experience to be utilized reliably. [ 22 23 24 25 38 ] Finally, although the reliability of the hug-up test demonstrated in the present study seems to be related to the more efficient activation of the supraspinatus, EMG and biomechanical evidence is lacking and needs to be investigated in further research. However, we do agree with Somerville's and Longo's opinion in that, because of the close relationship of the structures in the shoulder, no test can selectively detect a lesion in any one of the rotator cuff tendons, and any result from muscle tests might implicate a number of structures.…”

Section: Discussionmentioning

confidence: 74%

“…[ 20 21 ] The transdeltoid palpation test, first described by Codman[ 22 ] in 1934, has been used to diagnose full-thickness rotator cuff tears and yields a high sensitivity of 82–95.7%. [ 23 24 25 26 ] However, for all types of supraspinatus tears, the sensitivity of the transdeltoid palpation test decreased to 63–67%. [ 23 24 ] Furthermore, small, nonretracted defects and partial tears with predominantly articular surface involvement are more difficult to detect with this test,[ 26 ] and it requires some experience to be utilized reliably.…”

Section: Introductionmentioning

confidence: 99%

“…[ 23 24 25 26 ] However, for all types of supraspinatus tears, the sensitivity of the transdeltoid palpation test decreased to 63–67%. [ 23 24 ] Furthermore, small, nonretracted defects and partial tears with predominantly articular surface involvement are more difficult to detect with this test,[ 26 ] and it requires some experience to be utilized reliably. [ 23 26 ] Overall, the currently available commonly used physical tests for supraspinatus tears are poor diagnostic indicators with a wide range of sensitivity and specificity values.…”

Section: Introductionmentioning

confidence: 99%

“…[ 23 24 ] Furthermore, small, nonretracted defects and partial tears with predominantly articular surface involvement are more difficult to detect with this test,[ 26 ] and it requires some experience to be utilized reliably. [ 23 26 ] Overall, the currently available commonly used physical tests for supraspinatus tears are poor diagnostic indicators with a wide range of sensitivity and specificity values. Therefore, a more accurate physical test is needed for use in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

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The Hug-up Test

Liu

Yan

et al. 2016

Chinese Medical Journal

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Background:The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests.Methods:Between November 2012 and January 2014, 200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively. The hug-up test, empty can (EC) test, full can (FC) test, Neer impingement sign, and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears, with arthroscopic findings as the gold standard. Muscle strength was precisely quantified using an electronic digital tensiometer.Results:The prevalence of supraspinatus tears was 76.5%. The hug-up test demonstrated the highest sensitivity (94.1%), with a low negative likelihood ratio (NLR, 0.08) and comparable specificity (76.6%) compared with the other four tests. The area under the receiver operating characteristic curve for the hug-up test was 0.854, with no statistical difference compared with the EC test (z = 1.438, P = 0.075) or the FC test (z = 1.498, P = 0.067). The hug-up test showed no statistical difference in terms of detecting different tear patterns according to the position (χ2 = 0.578, P = 0.898) and size (Fisher's exact test, P > 0.999) compared with the arthroscopic examination. The interobserver reproducibility of the hug-up test was high, with a kappa coefficient of 0.823.Conclusions:The hug-up test can accurately detect supraspinatus tears with a high sensitivity, comparable specificity, and low NLR compared with the conventional clinical tests and could, therefore, improve the diagnosis of supraspinatus tears in clinical settings.

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Hug-up Test

Liu

Yan

et al. 2016

Chinese Medical Journal

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show abstract

“…But this can widely vary in every patient with some complaining of chronic pain, shoulder instability and decreased throwing speed [34]. Examination of the shoulder can reveal painful arc syndrome, crepitus, impingement and loss of strength in the affected side [35]. This has a considerable overlap with other shoulder pathologies such as subacromial bursitis and with full thickness rotator cuff tears.…”

Section: Diagnosismentioning

confidence: 99%