Predicting Size of Subscapularis TearsOne of the four muscle-tendon units of the rotator cuff in the shoulder is the subscapularis muscle. There are four clinical tests doctors can use to find out if the subscapularis is torn and how large the tear is. In this study each test is measured for accuracy.
A new test called the Bear-Hug test is included. In this test the patient places the hand of the painful shoulder on his or her opposite shoulder. The elbow is bent and the fingers are straight. The patient tries to keep the hand in that position while the examiner tries to pull the hand away. An external (outward) rotation force is applied. A positive test occurs when the patient can't hold the hand in place.
Researchers tested 68 patients with possible rotator cuff tears (RCTs) using three standard tests: the lift-off test, the belly-press test, the Napoleon test, and the new Bear-hug test. Results were compared with final findings on arthroscopic exam.
Here's what they found:
Overall the tests were very specific (not positive unless something was torn). Sensitivity (able to actually detect a tear) ranged from 17.6 per cent (lift-off test) to 60 per cent (bear-hug test).
The authors conclude all tests should be used to increase the chances of finding a tear and estimating its size. Since 40 per cent of subscapularis tears are missed with these tests, the surgeon is advised to check the subscapularis carefully for tears during the arthroscopic exam.
Johannes R. H. Barth, MD, et al. The Bear-Hug Test: A New and Sensitive Test for Diagnosing a Scapularis Tear. In The Journal of Arthroscopic and Related Surgery. October 2006. Vol. 22. No. 10. Pp. 1076-1084.
|*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.|
|All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.|