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First published on March 11, 2004, doi:10.1177/0363546503261723
This version was published on April 1, 2004
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The American Journal of Sports Medicine 32:655-661 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Diagnostic Value of Physical Tests for Isolated Chronic Acromioclavicular Lesions

Efstathios Chronopoulos, MD*, Tae Kyun Kim, MD, PhD{dagger}, Hyung Bin Park, MD*, Diane Ashenbrenner, RN* and Edward G. McFarland, MD*,{ddagger}

From the * Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, and the {dagger} Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

{ddagger} Address correspondence to Edward G. McFarland, MD, 10753 Falls Road, Suite 215, Lutherville, MD 21093 (e-mail: emcfarl{at}jhmi.edu).

Purpose: Chronic acromioclavicular joint lesions are a common source of pain and disability in the shoulder. The goal of this study was to evaluate diagnostic values of physical tests for isolated, chronic acromioclavicular joint lesions.

Study Design: A retrospective case-control study.

Methods: Between 1994 and 2002, 35 patients underwent a distal clavicle excision for isolated acromioclavicular joint lesions. The results of 3 commonly used examinations for acromioclavicular joint lesions were calculated for sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy.

Results: The cross body adduction stress test showed the greatest sensitivity (77%), followed by the acromioclavicular resisted extension test (72%) and active compression test (41%). The active compression test had the greatest specificity (95%). All tests had a negative predictive value of greater than 94%, but the positive predictive value was less than 30% for all tests. The active compression test had the highest overall accuracy (92%), followed by the acromioclavicular resisted extension test (84%) and the cross arm adduction stress test (79%). Combinations of the tests increased the diagnostic values for chronic acromioclavicular joint lesions.

Conclusions: These tests have utility in evaluating patients with acromioclavicular joint pathologic lesions, and a combination of these physical tests is more helpful than isolated tests.

Key Words: acromioclavicular joint • examination • arthritis • osteolysis • resection




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