This edition has six new tests (the ballottement test, Gerber's test, the painful arc sign
, the Thessaly test, the quad active test, and the Lelli test for anterior cruciate ligament injuries); a new evidence section for some tests, listing systematic reviews, meta-analyses, or articles that have addressed their reliability or diagnostic accuracy; and new color images.
The combination of the painful arc sign, drop-arm sign, and infraspinatus muscle strength test are helpful in detecting a full-thickness rotator cuff tear (SOR: B, a single prospective study).
(2) Investigators assessed 8 physical exam tests--the Neer impingement sign, Hawkins-Kennedy impingement sign, painful arc sign, supraspinatus muscle strength test, Speed's test, cross-body adduction test, drop-arm sign, and infraspinatus muscle strength test--to determine their diagnostic utility.
The combination of the painful arc sign, drop-arm sign, and weakness in external rotation (positive infraspinatus muscle strength test) produced the best likelihood ratios (LRs) for detecting frill-thickness rotator cuff tears (TABLE).