HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stetson, W. B. Articles by Templin, K. Search for Related Content PubMed PubMed Citation Articles by Stetson, W. B. Articles by Templin, K. Related Collections Shoulder

The Crank Test, the O’Brien Test, and Routine Magnetic Resonance Imaging Scans in the Diagnosis of Labral Tears

William B. Stetson, MD^, and Kevin Templin, ATC

University of Southern California, Department of Orthopedics, Los Angeles, and the Arthritis, Orthopedic, and Sports Medical Center, Glendale, California
Missouri Bone and Joint Center, St. Louis, Missouri

Presented as a poster presentation at the American Academy of Orthopaedic Surgeons 67th annual meeting, Orlando, Florida, March 2000, and at the American Shoulder and Elbow Society specialty day meeting, Anaheim, California, February 1999.

Address correspondence and reprint requests to William B. Stetson, MD, Arthritis, Orthopedic, and Sports Medical Center, 1505 Wilson Terrace, #200, Glendale, CA 91206

Background: Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically.

Purpose: We examined whether the crank or O’Brien tests were reliable tools for detecting glenoid labral tears.

Study Design: Nonrandomized prospective study.

Methods: Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain.

Results: The crank test result was positive in 29 patients (45%), and the O’Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O’Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%.

Conclusions: The O’Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.

This article has been cited by other articles:

				E J Hegedus, A Goode, S Campbell, A Morin, M Tamaddoni, C T Moorman III, and C Cook Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests Br. J. Sports Med., February 1, 2008; 42(2): 80 - 92. [Abstract] [Full Text] [PDF]

				M. K. Walsworth, W. C. Doukas, K. P. Murphy, B. J. Mielcarek, and L. A. Michener Reliability and Diagnostic Accuracy of History and Physical Examination for Diagnosing Glenoid Labral Tears Am. J. Sports Med., January 1, 2008; 36(1): 162 - 168. [Abstract] [Full Text] [PDF]

				Y.-S. Kim, J.-M. Kim, K.-Y. Ha, S. Choy, M.-W. Joo, and Y.-G. Chung The Passive Compression Test: A New Clinical Test for Superior Labral Tears of the Shoulder Am. J. Sports Med., September 1, 2007; 35(9): 1489 - 1494. [Abstract] [Full Text] [PDF]

				F. A. Barber, L. D. Field, and R. K.N. Ryu Biceps tendon and superior labrum injuries: decision-marking. J. Bone Joint Surg. Am., August 1, 2007; 89(8): 1844 - 1855. [Full Text] [PDF]

				C. M. Faustin, G. El Rassi, C. E. Toulson, S.-K. Lin, and E. G. McFarland Isolated Posterior Labrum Tear in a Golfer: A Case Report Am. J. Sports Med., February 1, 2007; 35(2): 312 - 315. [Full Text] [PDF]

				T. H. Myers, J. R. Zemanovic, and J. R. Andrews The Resisted Supination External Rotation Test: A New Test for the Diagnosis of Superior Labral Anterior Posterior Lesions Am. J. Sports Med., September 1, 2005; 33(9): 1315 - 1320. [Abstract] [Full Text] [PDF]

				J. J. Luime, A. P. Verhagen, H. S. Miedema, J. I. Kuiper, A. Burdorf, J. A. N. Verhaar, and B. W. Koes Does This Patient Have an Instability of the Shoulder or a Labrum Lesion? JAMA, October 27, 2004; 292(16): 1989 - 1999. [Abstract] [Full Text] [PDF]

				E. G. McFarland, T. K. Kim, and R. M. Savino Clinical Assessment of Three Common Tests for Superior Labral Anterior-Posterior Lesions Am. J. Sports Med., November 1, 2002; 30(6): 810 - 815. [Abstract] [Full Text] [PDF]