Evidence map›Paper›PMID 39702033›Full record

SynthesisBMC musculoskeletal disorders2024

Evidence-based approach to the shoulder examination for subacromial bursitis and rotator cuff tears: a systematic review and meta-analysis.

Qianzi Zhao, Preethika Palani, Nadine S Kassab, Milan Terzic, Monika Olejnik, Sichao Wang, Yma Tomassini-Lopez, Corey Dean, Richard A Shellenberger

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Assessment of the Validity and Reliability of the Turkish Version of the Modified Tampa Scale for Kinesiophobia in Patients With Shoulder Pain.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Qianzi ZhaoTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Preethika PalaniTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Nadine S KassabTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Milan TerzicTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Monika OlejnikTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Sichao WangMichigan State University, East Lansing, MI, USA.
Yma Tomassini-LopezTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Corey DeanTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
Richard A ShellenbergerTrinity Health Ann Arbor Hospital, Ann Arbor, MI, USA. Richard.Shellenberger@trinity-health.org.ORCID http://orcid.org/0000-0002-0883-8823

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionShoulder pain represents a common patient complaint evaluated in a primary care setting. Approximately two thirds of these patients have rotator cuff injuries, with rotator cuff tears (RCTs) and subacromial impingement syndrome (SIS) accounting for a majority of causes. An accurate and efficient diagnostic strategy focused on physical examination findings may lead to improved outcomes and less functional disability.

objectiveTo identify the most accurate physical examination tests for the diagnosis of RCT and SIS, we performed a systematic review and meta-analysis.

methodsThe database for our systematic review was compiled by using keywords and common indexing strategies to search PubMed, Ovid MEDLINE, Embase and the Cochrane Library from January 1, 1980, to March 15, 2024. Included studies evaluated a physical examination being performed prior to a reference standard diagnostic test for either RCT or SIS. Data was extracted in dual fashion and meta-analyses were performed regarding physical examination tests identified in our included studies.

resultsA total of twenty studies, which include 3,438 patients, met our inclusion criteria and had data extracted for statistical analysis. Data was adequate to perform meta-analyses on ten physical examination tests for RCT and five physical examination tests for SIS. There were six physical examination tests which had significant diagnostic odds ratios (DORs) when used in the diagnostic evaluation of suspected RCT, with the External Rotation Lag Sign at 90 Degrees having the highest magnitude of significance (DOR, 12.70; 95% CI, 3.68 - 43.86; P < .0001). Four physical examination tests had significant DORs for physical examination tests when used in the diagnostic evaluation of SIS, with the Yergason's Test having the highest magnitude of significance (DOR, 4.71; 95% CI; 2.16 - 10.32; P = .0001).

conclusionWe present a large body of low-quality evidence for the diagnostic accuracies of physical examination tests for the identification of both RCT and SIS. We have identified novel data for the accuracy of the External Rotation Lag Sign at 90 Degrees and the Internal Rotation Lag Sign that have high to moderate diagnostic accuracy for ruling in tears of the rotator cuff.

Indexed as

BursitisPhysical ExaminationRotator Cuff InjuriesShoulder Impingement SyndromeShoulder PainEvidence-Based MedicineHumansShoulder JointClinical diagnosisEvidence-based medicineMeta-analysisPhysical examinationRotator cuff tearSubacromial impingement syndrome

Identifiers

PMID39702033
PMCPMC11660602

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.