Diagnóstico clínico da ruptura do tendão subescapular com a manobra semiológica bear hug / Clinical diagnosis of subscapularis tendon tear using the bear hug semiological maneuver

RESUMO

OBJETIVO: Avaliar a manobra bear hug no diagnóstico clínico da lesão do tendão subescapular e compará-la com manobras previamente descritas (lift-off, Napoleão e belly press). MÉTODOS: Foram analisados 49 pacientes com lesão do manguito rotador, submetidos à artroscopia para reparo da lesão e avaliados previamente pelas manobras semiológicas citadas. RESULTADOS: Os valores diagnósticos obtidos para o teste bear hug foram os seguintes sensibilidade = 75%; especificidade = 56%; VPP = 62%; VPN = 70%; acurácia = 65%. CONCLUSÃO: Os maiores valores de sensibilidade e valor preditivo negativo foram obtidos com o bear hug. O maior valor de especificidade foi encontrado no teste lift-off. O teste belly press forneceu os maiores valores de especificidade, valor preditivo positivo e acurácia.

ABSTRACT

OBJECTIVE: To evaluate the Bear Hug maneuver for clinically diagnosing subscapularis tendon tears, and compare this with other maneuvers described previously (Lift-off, Napoleon and Belly Press). METHODS: Forty-nine patients with rotator cuff injuries who had undergone arthroscopy to repair the injury and had previously been assessed using the semiological maneuvers mentioned above were evaluated. RESULTS: The diagnostic values obtained for the Bear Hug test were as follows sensitivity 75%, specificity 56%, positive predictive value 62%, negative predictive value 70% and accuracy 65%. CONCLUSION: The highest sensitivity and negative predictive value values were obtained with the Bear Hug test. The highest specificity value was seen with the Lift-off test. The Belly press test gave the greatest specificity, positive predictive and accuracy values.