Accurate and reliable shoulder
tendinopathy examination maneuvers are essential for diagnosing and treating shoulder
pain; however, studies have reported varying results as to the accuracy of common maneuvers. Thus, data from a large, cross-sectional study were used to systematically quantify the reliability and accuracy of clinical diagnostic tests.
Baseline data from the WISTAH cohort study were used to evaluate inter-tester reliability and accuracy of common provocative shoulder
examination tests compared with a case definition of shoulder
Inter-tester reliability showed reliable consistency between providers with kappa coefficients between 89.5% and 94.8% for all tests. However, sensitivity
was generally poor (3.0% to 60.6%). Specificity was consistently high (96.2% to 99.6%).
provocative tests show low sensitivity
but high specificity, which implies that the primary utility of examination maneuvers is for their negative predictive values.