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Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review

updated

Tags: diagnosis, etiology, shoulder, biomechanics, chiropractic, pro, head/neck, manual therapy, treatment, controversy, debunkery, spine

Two articles on PainSci cite Wright 2013: (1) Your Back Is Not Out of Alignment(2) Is Diagnosis for Pain Problems Reliable?

PainSci notes on Wright 2013:

From the abstract: “no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders.

METHODS: A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper.

RESULTS: Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively.

CONCLUSIONS: Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

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