Validity of Cyriax's Test in Young Male with Shoulder Pain Compared to Ultrasonographic Findings

ABSTRACT

BACKGROUND: This study was designed to evaluate the validity of the Cyriax's selective tension examination as a diagnostic tool in young male with shoulder pain compared to ultrasonographic findings. METHODS: Twenty young male patients with 26 shoulder pain cases were prospectively included in this study. All had a physical examination performed by Cyriax's selective tension method. As a diagnostic gold standard, ultrasonographic examination was carried out within one week of the physical examination by two specialists. RESULTS: The most common findings by sonographic evaluation were sub-deltoid bursitis (65.4%). Sub-deltoid bursal effusion without rotator cuff injury were 10 cases (58.8%) and 17 cases (41.2%) showed combined rotator cuff lesion. The most common diagnoses by physical examination were sub-deltoid bursitis (46.2%) followed by supraspinatus tendon lesion (19.2%). Clinical assessment by physical examination showed low sensitivity in the diagnosis of rotator cuff lesion (42.9%) and sub-deltoid bursitis (70.6%) but high sensitivity and specificity in the diagnosis of shoulder joint instability (sensitivity 100%, specificity 91.7%). CONCLUSION: This study suggest that the validity of Cyriax's selective tension test for the diagnosis of shoulder pain are questionable.