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Doctors Put Shoulder Tests to the Test

Pain on top of the shoulder where the collarbone meets the shoulder blade bone is a common finding with acromioclavicular (AC) joint problems. Many patients injure the AC joint during physical activity. Weight lifting, push-ups, or dips are the most common activities known to cause AC injury.

Healthcare providers use many tests to isolate the cause of shoulder pain. But some shoulder tests turn out positive for other problems when the real problem is AC joint injury. Finding a test that will always be positive with an AC joint injury is the goal of this study.

Doctors in Korea used three specific shoulder tests with two groups of patients. The tests were checked to see how good they were. Reliability shows if the test gives the same result when it's repeated. Sensitivity reflects the test's ability to give a true positive when there is a problem. Specificity means that the test gives a true negative when there isn't a problem.

All patients had a shoulder problem. The first group had chronic AC joint pain and got relief of symptoms with a steroid injection. The second group had surgery for a shoulder joint problem other than an AC injury. The authors found that two tests were reliable, sensitive, and specific. The first was the cross body adduction stress test. The second was the AC resisted extension test. The third test (active compression) had high specificity but low sensitivity.

References: Efstathios Chronopoulos, MD, et al. Diagnostic Value of Physical Tests for Isolated Chronic Acromioclavicular Lesions. In The American Journal of Sports Medicine. March/April 2004. Vol. 32. No. 2. Pp. 655-661.

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