The Authenticity Evaluation Of Physical Examination And MRI In The Diagnosis Of Rotator Cuff Tear

objective: To evaluate the effectiveness and reliability of shoulder’s clinical physical exzaminationand MRI in the diagnosis of the supraspinatus tears.Method: Retrospective analysis the76shoulders which undergone arthroscopy from March2012toApril2013in the fourth department of Orthopaedics,Wangjing Hospital of China Academy of ChineseMedicine Sciences,32patients(male16,woman16)had supraspinatus tears diagnosed by shoulderarthroscopy.other44patients (male18,woman26) had SIS and SLAP without RCT.All the patients hadaccepted the uniform physical examination and MRI before operation.Arthroscopic findings are the goldstandard for diagnosis. Using statistical analysis the consequences of Neer,s test, Hawkins,test, arch pain,Drop arm test, Job,s test, sleep pain, subacromial or greater tuberosity tenderness (test)and MRI which areapplied to diagnose the supraspinatus tears.Calculate the authenticity index by software package ofSPSS13.0.Results: Arch pain had the highest sensitivity (81.3%),Jobe’s test had the highestspecificity(81.8%),Neer,s test had the highest Youden index(35.2%),the next one is sleep pain with0.333;Job,s test, sleep pain and Hawkins,test had the specificity is95.5%after series connection. The sensitivityand specificity of MRI are87.5%and90.9%.Conclusion:1.Arch pain and Jobe’s test have the maximal value to the diagnosis of supraspinatus tears in shoulderphysical examination. Arch pain is helpful to early finding, meanwhile the Jobe’s test is helpful to definediagnosis.2.Single examination has low diagnostic index which can be improved by combined physicalexaminations. Using Jobe’s test, sleep pain and Hawkins test together had higher correct rate in our studywhich is easy to achieve.3. As a noninvasive examination, MRI with high soft tissue resolution can display the condition andpathological changes of the rotator cuff tears in multiplane, In our study, the MRI diagnositic sensitivityand specificity of supraspinatus tears are87.5%and90.9%. So MRI take a valuable part in the diagnosis ofrotator cuff tears.It’s the first choice to diagnosis.