Diagnostic Accuracy of Physical Tests and Imaging Techniques in Patients with Shoulder Impingement Syndrome.

Background. A common cause of shoulder pain is attributable to the impingement syndrome. The objectives of this systematic review are: 1) to investigate the usefulness of clinical tests and their psychometric qualities in the clinical diagnosis of subacromial shoulder impingement; 2) to investigate the accuracy of different imaging methods to identify structural correlates related to rotator cuff injuries as indirect confirmation of subacromial impingement syndrome. Materials and methods. This systematic review was carried out following the indications contained in the PRISMA checklist. The methodological quality of the studies included was assessed through the AMSTAR 2. Results. Several studies agree that no test improves the post-test probability of detecting subacromial impingement and, therefore, are inaccurate. Ultrasound, Magnetic Resonance Imaging and Magnetic Resonance Arthrography have the same level of sensitivity and specificity in the detection of complete lesions of the rotator cuff. For partial injuries it seems that there is a lower sensitivity in view of high specificity, especially with ultrasound. Discussion and conclusions. The present review confirms the poor diagnostic ability of clinical tests for subacromial shoulder impingement and it highlights the criticism in imaging employment in the complex process of the clinical framing of this syndrome. [ABSTRACT FROM AUTHOR]