Diagnostic performances of the physical examination tests for various shoulder problems: Literature Review

7th ASIA PACIFIC International Modern Sciences Congress, Jakarta, Endonezya, 4 - 05 Kasım 2022, ss.157, (Özet Bildiri)

Numerous physical examinations have been developed as they are feasible methods in clinical

settings compared to expensive assessment approaches such as magnetic resonance imaging.

Physical examination tests have been used by clinicians to discriminate and diagnose shoulder

problems. The literature review aimed to examine the diagnostic performances of the physical

examination tests used in shoulder clinics.

Literature was elaborated using previously published 6 systematic reviews. As the latest systematic

review was published in early 2017, four databases (Scopus, PubMed, Web of Science and Embase)

were searched systematically from 2017 January to October 2022. Sensitivity, specificity, positive

likelihood ratio, negative likelihood ratio and diagnostic odds ratio scores were extracted. If the

diagnostic odds ratio of a physical test was not reported, the ratio was calculated using sensitivity

and specificity, or positive and negative likelihood ratios.

The systematic search yielded 3101 titles and abstracts after duplication removal. In the full-text

examination, 25 publications were examined. 41 shoulder physical examinations were obtained

from the systematic search and the previous 6 systematic reviews. The sensitivity and specificity

scores ranged from 0.12 to 0.99. The positive and negative likelihood ratio scores were between

0.02 and 61. The diagnostic odd ratio scores of all physical examinations were greater than 1 for

specific shoulder pathology.

All physical examinations had an acceptable diagnostic performance for one or a limited number of

shoulder pathologies. A single physical examination test is not useful to discriminate various

shoulder problems as diagnostic odds ratio scores change for different shoulder pathologies.

Therefore, a combination of shoulder physical examination tests should be used for more precise

clinical decisions to manage better shoulder problems.