Abstract

Background: Shoulder pain is one of the most common complaints encountered in Rheumatological practice and often leads to considerable disability.
Aim of the study: to assess the diagnostic value of six clinical tests for identifying pathologies in patients complaining of shoulder pain, and utilize ultrasound examination (US) as an imaging modality to confirm the clinical diagnosis.
Patients and Methods: This Cross-sectional study included 80 consecutive patients who presented with shoulder pain and at least one of the subsequent features: pain during daily activities, pain at night, neck pain, arm paresthesia, or numbness. Six clinical tests that elicit tenderness in the shoulder were performed and then ultrasonography was performed to confirm the diagnosis.
Results: A total of 80 participants were enrolled in this study. Tenderness in various parts of the shoulder to deep palpation was the most accurate test for predicting the diagnosis with a sensitivity of 100% and specificity of 14.5%. There was a significant difference between shoulder pain in the dominant and non-dominant side (p-value <0.001), and significant differences between the clinical examination results and US findings for 5 tests, except for the drop-arm test which was insignificant (p = 1.000). There were no significant differences between diabetic and non-diabetic patients regarding all the shoulder ultrasound findings (p > 0.05).
Conclusion: Although clinical tests are insufficient for diagnosis of the shoulder pathologies, the examination of the patient still plays an important role. However, Ultrasonography should be used for all patients suffering from a painful shoulder in order to confirm the diagnosis.