Diagnosegenauigkeit klinischer Tests bei einem Impingement-Syndrom der Schulter

Zusammenfassung

In der Literatur findet sich eine Vielzahl klinischer Tests zur Diagnose eines Impingement-Syndroms der Schulter. Die vorliegende Arbeit stellt diese Testverfahren systematisch dar und vergleicht ihre Validität zur Diagnosestellung und Identifizierung auslösender Strukturen.

Die gefundenen Studien beschreiben vergleichbare Daten zur Identifizierung eines Schulter-Impingement-Syndroms und zur Strukturverifizierung. Insgesamt erreichten 12 der eingeschlossenen Studien eine ausreichend gute bis hohe Bewertung der methodischen Qualität. Bei 18 Tests ergaben sich ausreichend hohe Wahrscheinlichkeiten zur Diagnosesicherung und Weichteilidentifizierung.

Abstract

The literature reports a variety of clinical tests for the diagnosis of shoulder impingement. This article systematically describes these tests and compares their validity for diagnosis and for the identification of symptom inducing structures.

The identified studies describe comparable data for the identification of shoulder impingement and for structural verification. In summary, 12 of the included studies attained a satisfactory “good” to “high” rating for methodological quality. 18 tests produced an adequately high likelihood for diagnosis and soft tissue identification.

Schlüsselwörter

Schulter-Impingement-Syndrom - diagnostische Tests - klinische Tests - Validität

Keywords

shoulder impingement - diagnostic tests - clinical tests - validity

• Literatur

• 1 Ardic F, Kahraman Y, Kacar M et al. Shoulder Impingement Syndrome: Relationships between clinical, functional and radiologic findings. Am J Phys Med Rehabil 2006; 85: 53-60
• 2 Barth JRH, Burkhart SS, DeBeer JF. The Bear-Hug Test: a new and sensitive test for diagnosing a subscapularis tear. J of Arthroscopic and Related Surgery 2006; 22: 1076-1084
• 3 Bartsch M, Greiner S, Haas NP et al. Diagnostic values of clinical tests for subscapularis lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18: 1712-1717
• 4 Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Transaction 1986; 10: 216-221
• 5 Birtane M, Calis M, Akgün K. The diagnostic value of magnetic resonance imaging in subacromial impingement syndrome. Yonsei Med J 2001; 42: 418-424
• 6 Caliş M, Akgün K, Birtane M et al. Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis 2000; 59: 44-47
• 7 Campbell RS, Dunn A. External impingement of the shoulder. Semin Musculoskelet Radiol 2008; 12: 107-126
• 8 Castagna A, Garofalo R, Cesari E et al. Anterior and posterior internal impingement – an evidence-based review. Br J Sports Med 2010; 44: 382-388
• 9 Chao S, Thomas S, Yucha D. An electromyographic assessment of the “bear hug”: an examination for the evaluation of the subscapularis muscle. Arthroscopy 24: 1265-1270
• 10 Chronopoulos E, Kim TK, Park HB et al. Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med 2004; 32: 655
• 11 Chung-Ming Yu, Chih-Hwa Chen, Hsien-Tao Liu et al. Subacromial Injections of Corticosteroids and Xylocaine for Painful Subacromial Impingement Syndrome. Chang Gung Med J 2006; 29: 474-479
• 12 Codman EA. The pathology associated with the rupture of the supraspinatus tendon. Ann Surg 1931; 93: 348-359
• 13 Codman EA. The shoulder – Rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston: Thomas Todd; 1934
• 14 Codman EA. Rupture of the supraspinatus. Am J Surg 1938; 42: 603-626
• 15 Deeks JJ, Altman DG. Diagnostic tests 4: likelihood ratios. BMJ 2004; 329: 168-169
• 16 Diemer F, Sutor V. Praxis der medizinischen Trainingstherapie. II: Halswirbelsäule und obere Extremität. Stuttgart: Thieme; 2010
• 17 Fodor D, Poanta L, Felea I et al. Shoulder Impingement Syndrome: Correlations between clinical tests and ultrasonographic findings. Medsportpress 2009; 2: 120-126
• 18 Fox JA, Noerdlinger MA, Romeo AA. Arthroskopic subscapularis repair. Tech Shoulder Elbow Surg 2003; 4: 154-168
• 19 Frank W. Textskriptum evidenzbasiertes Forschen Musculoskeletal Physiotherapy Upgrade OMT. Krems: Donau-Universität Krems; 2011
• 20 Gansen HK, Irlenbusch U. Die neuromuskuläre Insuffizienz der Rotatorenmanschette als Ursache des funktionellen Impingements: muskelbioptische Untersuchungen am Schultergelenk. Z Orthop 2002; 40: 65-71
• 21 Gerber C, Krushell RJ. Isolated rupture of the tendon of the suscapularis muscle – Clinical features in 16 cases. J Bone Joint Surg Br 1991; 73: 389-394
• 22 Gilcreest EL, Albi P. Unusual lesions of muscles and tendons of the shoulder girdle and upper arm. Surg Gynecol Obstet 1939; 68: 903-917
• 23 Gill TJ, McIrvin E, Kocher MS et al. The relative importance of acromial morphology and age with respect to rotatorcuff pathology. J of Shoulder and Elbow Surgery 2002; 11: 327-330
• 24 Goutallier D, Postel JM, Bernageau J et al. Fatty muscle degeneration in cuff ruptures: pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994; 304: 78-83
• 25 Gumina S, Bertino A, DiGiorgio G et al. A new test of resistance in the diagnosis of postero superior rotator cuff tears. Chir Organi Mov 2008; 91: 85-86
• 26 Hawkins RJ, Kennedy JC. Impingement syndrome athletes. Am J Sports Med 1980; 8: 151-158
• 27 Hedtmann A, Heers G, Heidersdorf S. Bildgebende Verfahren an der Schulter. Arthroskopie 2001; 14: 74-93
• 28 Hedtmann A, Fett H. Sonographie der Rotatorenmanschette. Orthopäde 2002; 31: 236-246
• 29 Hedtmann A, Heers G. Klinische und radiologische Untersuchung der Schulter. Orthopädie und Unfallchirurgie up2date 1 2006; 271-302
• 30 Hedtmann A, Heers G. Bildgebende Verfahren bei Rotatorenmanschettendefekten. Der Orthopäde 2007; 36: 796-809
• 31 Hertel R, Ballmer FT, Lambert SM et al. Lag signs in the diagnosis of rotator cuff rupture. J of Shoulder and Elbow Surgery 1996; 5: 307-313
• 32 Holtby R, Razmjou H. Validity of the supraspinatus test as a single clinical test in diagnosing patients with rotator cuff pathology. J Orthop Sports Phys Ther 2004; 34: 194-200
• 33 Itoi et al. 1999 ((restl. bibl. Angaben?))
• 34 Jobe FW, Moynes DR. Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries. Am J Sports Med 1982; 10: 336-339
• 35 Jobe FW, Jobe CM. Painful athletic injuries oft the shoulder. Clin Orthop Relat Res 1983; 173: 117-124
• 36 Kapandji I. Funktionelle Anatomie der Gelenke: Schematisierte und kommentierte Zeichnungen zur menschlichen Biomechanik. Obere Extremität, untere Extremität, Rumpf und Wirbelsäule. Stuttgart: Thieme; 2009
• 37 Kelly BT, Kadrmas WR, Speer KP. The manual muscle examination for rotator cuff strength: an electromyographic investigation. Am J Sports Med 1996; 24: 581-588
• 38 Kelly SM, Brittle N, Allen GM. The value of physical tests for subacromial impingement syndrome: a study of diagnostic accuracy. Clin Rehabil 2010; 24: 149-158
• 39 Kessel L, Watson M. The painful arc syndrome. Clinical classification as a guide to management J Bone Joint Surg Br 1977; 59: 166-172
• 40 Kibler BW, Sciascia A. What went wrong and what to do about it – pitfalls in the treatment of shoulder impingement. Instr Course Lect 2008; 57: 103-112
• 41 Kim E, Jeong HJ, Lee KW et al. Interpreting positive signs of the supraspinatus test in screening for torn rotator cuff. Acta Med Okayama 2006; 60: 223-228
• 42 Leroux JL, Thomas E, Bonnel F et al. Diagnostic value of clinical tests for shoulder impingement syndrome. Rev Rhum Engl Ed 1995; 62: 423-428
• 43 Lyons AR, Tomlinson JE. Clinical Diagnosis of tears of the rotator cuff. J Bone Joint Surg Br 1992; 74B: 414-415
• 44 MacDonald PB, Clark P, Sutherland K. An analysis of the diagnostic accuracy of the Hawkins and Neer subacromial. J Shoulder Elbow Surg 2000; 9: 299-301
• 45 Magosch P, Scheiderer WD. Anatomie, Biomechanik und Pathomechanik der Schulter. In: Habermeyer P, Lichtenberg S, (Hrsg) Konservative Therapie und Rehabilitation von Schultererkrankungen. München: Urban & Fischer Elsevier; 2012
• 46 Malhi AM, Khan R. Correlation between clinical diagnosis and arthroskopic findings of the shoulder. Postgrad Med J 2005; 81: 657-659
• 47 Mayerhöfer ME, Breitenseher MJ. Schulter-Impingement. Der Radiologe 2004; 44: 569-577
• 48 McFarland EG, Selhi HS, Keyurapan E. Clinical evaluation of impingement: what to do and what works. J Bone Joint Surg Am 2006; 88: 432-441
• 49 McLaughlin HL. On the “frozen” shoulder. Bull Hosp Joint Dis 1951; 12: 383-393
• 50 Mehrholz J. Wissenschaft erklärt: Sensitivität und Spezifität diagnostischer Tests. physiopraxis 2007; 1: 16
• 51 Meister K, Buckley B, Batts J. The posterior impingement sign: diagnosis of rotator cuff and posterior labral tears secondary to internal impingement in overhand athletes. The American Journal of Orthopaedics 2004; 33: 412-415
• 52 Michener LA, McClure PW, Karduna AR. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clin Biomech (Bristol, Avon) 2003; 18: 369-379
• 53 Michener LA, Walsworth MK, Doukas WC et al. Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Arch Phys Med Rehabil 2009; 90: 1898-1903
• 54 Nanda R, Gupta S, Kanapathipillai P et al. An assessment of the inter examiner reliability of clinical tests for subacromial impingement and rotator cuff integrity. Eur J Orthop Surg Traumatol 2008; 18: 495-500
• 55 Naredo E, Aguado P, DeMiguel E et al. Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann Rheum Dis 2002; 61: 132-136
• 56 Natsis K, Tsikaras P, Totlis T et al. Correlation between the four types of acromion and the existence of enthesophytes: a study on 423 dried scapulas and review of the literature. Clin Anat 2007; 20: 267-272
• 57 Nebelung W, Wiedemann E. Schulterarthroskopie. Berlin: Springer; 2002
• 58 Neer CS. Anterior acromioplasty fort the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972; 54: 41-50
• 59 Neer CS. Impingement lesions. Clin Orthop Relat Res 1983; 173: 70-77
• 60 Oesch P, Hilfiker R, Keller S et al. Assessments in der muskuloskeletalen Reha. Bern: Huber; 2007
• 61 Opsha O, Malik A, Baltazar R et al. MRI of the rotator cuff and internal derangement. European J of Radiol 2008; 68: 36-56
• 62 Park HB, Yokota A, Gill HS et al. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am 2005; 87: 1446-1455
• 63 Salaffi F, Ciapetti A, Carotti M et al. Clinical value of single versus composite provocative clinical tests in the assessment of painful shoulder. J Clin Rheumatol 2010; 16: 105-108
• 64 Scheibel M, Habermeyer P. Aktuelle klinische Untersuchung der Schulter. Der Orthopäde 2005; 34: 267-284
• 65 Schomacher J. Manuelle Therapie: Bewegen und Spüren lernen. Stuttgart: Thieme; 2011
• 66 Schroeder HP, Kuiper SD, Botte MJ. Osseous Anatomy of the Scapula. Clinical Orthopaedics & Related Research 2001; 383: 131-139
• 67 Schuntermann MF. Einführung in die ICF: Grundkurs, Übungen, offene Fragen. Lech: Ecomed; 2009
• 68 Shah NN, Bayliss NC, Malcom A. Shape of the acromion: Congenital or acquired: a macroscopic, radiographic and microscopic study of the acromion. J Shoulder Elbow Surg 2001; 10: 309-316
• 69 Silva L, Andréu JL, Muñoz P et al. Accuracy of physical examination in subacromial impingement syndrome. Rheumatology (Oxford) 2008; 47: 679-683
• 70 Tokish JM, Decker MJ, Ellis HB. The belly-press test for the physical examination of the subscapularis muscle: electromyographic validation and comparison to the lift-off test. J of Shoulder and Elbow Surg 2003; 12: 427-430
• 71 Trommer T, Fuhrmann R, Liesaus E et al. Das subacromiale Impingementsyndrom. Z Orthop 2006; 144: 83-101
• 72 Ure BM, Tiling T, Kirchner R et al. Zuverlässigkeit der klinischen Untersuchung der Schulter im Vergleich zur Arthroskopie. Unfallchirurg 1993; 96: 382-386
• 73 Urwin M, Symmons D, Allison T et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998; 57: 649-655
• 74 Walch G, Boulahia A, Calderone S et al. The dropping and hornblower’s signs in evaluation of rotator cuff tears. J of Bone and Joint Surgery (Br) 1998; 80-B: 624-628
• 75 Walton J, Mahajan S, Paxinos A. Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surg Am 2004; 86: 807-812
• 76 Werner CML, Blumenthal S, Curt A et al. Subacromial pressures in vivo and effects of selective experimental suprascapular nerve block. J of Shoulder and Elbow Surgery 2006; 15: 319-323
• 77 Whiting P, Rutjes AWS, Reitsma JB et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Medical Research Methodology 2003; 3: 25
• 78 Whiting P, Rutjes AWS, Reitsma JB et al. Sources of variation and bias in studies of diagnostic accuracy: a systematic review. Annals of Internal Medicine 2004; 140: 189-202
• 79 Whiting P, Harbord R, Kleijnen J. No role for quality scores in systematic reviews of diagnostic accuracy studies. BMC Medical Research Methodology 2005; 5: 19
• 80 Whiting PF, Weswood ME, Rutjes AWS et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Medical Research Methodology 2006; 6: 9
• 81 Wolf EM, Agrawal V. Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears. J of Shoulder and Elbow Surgery 2001; 10: 470-473
• 82 Yamakado K. The targeting accuracy of subacromial injection to the shoulder: an arthrographic evaluation. J of Arthroscopy 2002; 18: 887-891
• 83 Yergason RM. Supination sign. J Bone Joint Surg 1931; 131: 60
• 84 Yocum LA. Assessing the shoulder. History, physical examination, differential diagnosis and special tests used Clin Sports Med 1983; 2: 281-289
• 85 Zaslav KR. Internal rotation resistance strength test: a new diagnostic test to differentiate intraarticular pathology from outlet (Neer) impingement syndrome in the shoulder. J of Shoulder & Elbow Surgery 2001; 10: 23-27
• 86 Zlatkin MB, Ianotti JP, Roberts MC. Rotator cuff tears: diagnostic performance of MRG imaging. Radiology 1989; 172: 223-229