Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review

Br J Sports Med. 2013 Sep;47(14):886-92. doi: 10.1136/bjsports-2012-091573. Epub 2012 Oct 18.


Objective: To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders.

Methods: A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper.

Results: Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively.

Conclusions: Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

Keywords: Evidence based reviews; Shoulder injuries.

Publication types

  • Evaluation Study
  • Review
  • Systematic Review

MeSH terms

  • Acromioclavicular Joint / injuries
  • Diagnosis, Differential
  • Dyskinesias / diagnosis
  • Humans
  • Joint Diseases / diagnosis*
  • Joint Diseases / physiopathology
  • Joint Dislocations / diagnosis
  • Joint Dislocations / physiopathology
  • Myalgia / etiology
  • Myalgia / physiopathology
  • Physical Examination / methods
  • Physical Examination / standards*
  • Range of Motion, Articular / physiology
  • Scapula / physiopathology*
  • Sensitivity and Specificity
  • Shoulder Impingement Syndrome / diagnosis
  • Shoulder Impingement Syndrome / physiopathology
  • Shoulder Pain / etiology
  • Shoulder Pain / physiopathology