HYPOTHESIS: This study reassessed the sensitivity and the specificity of the external rotator lag sign (ERLS) for diagnosis of supraspinatus tears in a large cohort of patients. MATERIALS AND METHODS: The ERLS was used to assess 401 consecutive patients with 406 painful shoulder conditions. The clinical diagnosis was controlled either arthroscopically or by open surgery. RESULTS: For isolated full-thickness supraspinatus tears, the ERLS had a sensitivity of 56% and a specificity of 98%. When the lesion involved the infraspinatus and the teres minor the sensitivity improved substantially. There was a strong correlation between the extension of the tear and the amount of the lag. The lag increased from 7 degrees for an isolated rupture of the supraspinatus tendon to 26 degrees in case of extension to the teres minor. CONCLUSION: The ERLS is highly specific and acceptably sensitive for diagnosis of full-thickness tears, even in case of an isolated lesion of the supraspinatus tendon. LEVEL OF EVIDENCE: Level 2; Prospective cohort treatment study.

External rotation lag sign revisited: Accuracy for diagnosis of full thickness supraspinatus tear

CASTOLDI, Filippo;BLONNA, Davide;
2009-01-01

Abstract

HYPOTHESIS: This study reassessed the sensitivity and the specificity of the external rotator lag sign (ERLS) for diagnosis of supraspinatus tears in a large cohort of patients. MATERIALS AND METHODS: The ERLS was used to assess 401 consecutive patients with 406 painful shoulder conditions. The clinical diagnosis was controlled either arthroscopically or by open surgery. RESULTS: For isolated full-thickness supraspinatus tears, the ERLS had a sensitivity of 56% and a specificity of 98%. When the lesion involved the infraspinatus and the teres minor the sensitivity improved substantially. There was a strong correlation between the extension of the tear and the amount of the lag. The lag increased from 7 degrees for an isolated rupture of the supraspinatus tendon to 26 degrees in case of extension to the teres minor. CONCLUSION: The ERLS is highly specific and acceptably sensitive for diagnosis of full-thickness tears, even in case of an isolated lesion of the supraspinatus tendon. LEVEL OF EVIDENCE: Level 2; Prospective cohort treatment study.
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External rotation lag sign; rotator cuff tear; supraspinatus tear; Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Humans; Injury Severity Score; Male; Middle Aged; Neurologic Examination; Physical Examination; Preoperative Care; Probability; Range of Motion, Articular; Retrospective Studies; Rotator Cuff; Sensitivity and Specificity; Shoulder Joint; Tendon Injuries; Young Adult; Orthopedics and Sports Medicine; Surgery
Castoldi, Filippo; Blonna, Davide; Hertel, Ralph
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/136490
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