Internal rotation resistance strength test: a new diagnostic test to differentiate intra-articular pathology from outlet (Neer) impingement syndrome in the shoulder

J Shoulder Elbow Surg. Jan-Feb 2001;10(1):23-7. doi: 10.1067/mse.2001.111960.

Abstract

This prospective study introduces a new sign to differentiate between outlet impingement and non-outlet (intra-articular) causes of shoulder pain in patients with positive impingement sign: the internal rotation resistance strength test (IRRST). It was hypothesized that positive test results are predictive of non-outlet impingement, whereas negative test results confirm outlet impingement. A prospective comparison between IRRST and arthroscopic findings of 115 consecutive patients showed the test to be highly accurate in differentiating between these two diagnoses (positive predictive value 88%, negative predictive value 96%, sensitivity 88%, specificity 96%, and accuracy 94.5%). The IRRST, in conjunction with impingement and apprehension signs, adds to our armamentarium of tests that distinguish between subacromial outlet impingement and intra-articular forms of pathology.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy / methods*
  • Cohort Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / etiology
  • Physical Examination / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Range of Motion, Articular / physiology*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Shoulder Dislocation / diagnosis*
  • Shoulder Dislocation / surgery
  • Shoulder Impingement Syndrome / diagnosis*
  • Shoulder Impingement Syndrome / surgery