Comparison of efficacy of supraspinatus tendon tears diagnostic tests: a prospective study on the "full-can," the "empty-can," and the "Whipple" tests

Musculoskelet Surg. 2021 Aug;105(2):149-153. doi: 10.1007/s12306-019-00631-0. Epub 2019 Nov 5.

Abstract

Purpose: This study compares the clinical results of the Whipple, empty-can, and full-can tests to detect supraspinatus tendon tears. We determined the sensitivities, specificities, and positive and negative predictive values of each test with respect to the intraoperative supraspinatus tendon lesion confirmation.

Methods: We examined 61 patients (26 women, 35 men) presenting for arthroscopic surgery with functional disability or persisting shoulder pain. All the patients underwent Whipple, empty-can, and full-can testing. We correlated the clinical results of the tests with the confirmation of a supraspinatus tendon lesion by direct arthroscopic visualization.

Results: We examined 34 right and 27 left shoulders. For full and partial supraspinatus tendon tears, the Whipple test showed a sensitivity of 88.6% and a specificity of 29.4%, whereas the empty-can test and the full-can test had sensitivities of 88.6% and 75.0%, and specificities of 58.8% and 47.1%, respectively.

Conclusions: Compared with the empty-can test and the full-can test, the Whipple test was less specific, while its sensitivity was equal to that of the empty-can test and higher than that for the full-can test. Because of its low specificity, the Whipple test has a high risk of false-positive results in comparison with the other tests.

Keywords: Clinical examination shoulder; Rotator cuff tear; Whipple test.

MeSH terms

  • Arthroscopy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prospective Studies
  • Rotator Cuff
  • Rotator Cuff Injuries* / diagnostic imaging
  • Rotator Cuff Injuries* / surgery
  • Tendon Injuries* / diagnosis
  • Tendon Injuries* / surgery
  • Tendons