Comparison of Physical Examinations and Ultrasonographic Findings in Patients with Painful Shoulder

Background with Objective: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder. The aim of this study was to compare the physical examinations with ultrasonographic findings in patients with painful shoulder. Methods: This Prospective observational Study was carried out among 101 patients attending at the Department of Physical Medicine and Rehabilitation, Dhaka Medical College and Hospital (DMCH), Dhaka within the defined period from July 2021 to December 2021. Ethical clearance was obtained from the Ethical review committee of Dhaka Medical College Hospital. Purposive sampling was done according to availability of the patients. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.1). Results: Majority of the patients (59.4%) were in 41-50 years age group where the mean age of the patients was 50.3 ± 7.9 years and 51 (50.5%) patients were male. On physical examination, 76 (75.2%) patients were Neer tests positive, 62 (61.4%) were Jobe’s test for supraspinatus positive and 37 (36.6%) were Yegarson’s test for the long head of the biceps brachii positive. Most of the patients (93.1%) were Patte’s test for infraspinatus negative. USG findings shows that 47 (46.5%) had impingement, 30 (29.7%) had Osteoarthritis in acromioclavicular joint, another 30 (29.7%) had Supranpinatous tendinosis, 25 (24.8%) had Subdeltoid bursitis, 22 (21.8%) had partial tear of supraspinatous. Neer tests had 47.4% sensitivity and 56.0% specificity with 49.5% accuracy. Jobe’s test for supraspinatus had 66.7% sensitivity and 40.8% specificity with 48.5% accuracy. Patte’s test for infraspinatus had 95.8% accuracy and Gerber’s lift-off test for subscapularis had 84.1% accuracy while Yegarson’s test for the long head of the biceps brachii had 79.2% accuracy Conclusion: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.