None listed
Conditions
Brief summary
Acromioclavicular (AC) joint pathology is a common cause of shoulder pain. The location of pain originating from the AC joint can be diverse and patients are often not able to identify the exact location. In most patients the pain will be located in an area bounded by the mid-part of the clavicle and the deltoid insertion, but the pain has also been shown to radiate to the radial side of the forearm into the thumb. AC joint pathology can occur in isolation, but is often associated with other causes of shoulder pain, such as subacromial impingement or rotator cuff pathology. Surgical treatment of other causes of shoulder pain can affect the AC joint, and arthroscopic acromioplasty may have detrimental effects on an already compromised AC joint. Conversely, residual AC joint pathology has been shown to have a negative effect on the outcome of surgery to the rotator cuff. Detection of AC joint pathology is therefore crucial in the treatment of patients with any type of shoulder problem and various clinical tests have been described to asses AC joint pathology. The primary aim of this study was to assess the diagnostic sensitivity of the BvR (Bell-van Riet) test, when compared with other tests.
Interventions
The patient stands facing the examiner and the shoulder is passively elevated to 90 degrees, and then fully adducted. The elbow is then extended, with the shoulder in internal rotation (IR) and the forearm pronated. During this manoeuvre, the examiner supports the arm of the patient with his opposite hand, while resting the other hand on the patient’s opposite shoulder to maintain adduction and to prevent rotation of the patient’s upper body. If pain is present, this is considered to be a positi
The patient stands facing the examiner and the shoulder is passively elevated to 90 degrees, and then fully adducted. The elbow is then extended, with the shoulder in internal rotation (IR) and the forearm pronated. During this manoeuvre, the examiner supports the arm of the patient with his opposite hand, while resting the other hand on the patient’s opposite shoulder to maintain adduction and to prevent rotation of the patient’s upper body. If pain is present, this is considered to be a positive cross arm adduction sign. The patient is then asked to resist the examiner’s downwards force on the forearm . In a positive BvR test, this results in pain and the inability of the patient to maintain the arm in the adducted and elevated position. As a further assessment in this study the test was then repeated with the adducted arm in external rotation (ER). This test is performed once only for diagnostic purposes and takes approximately 7 seconds to complete
Sponsors
A/Prof. Simon Bell
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
20 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
ALL patients with isolated AC (acromio clavicular ) joint symptoms were included sequentially in this study, INCLUSION CRITERIA were defined as the presence of localised AC joint tenderness or at least one positive AC joint compression tests. In addition, all post-injection tests had to be negative for patients to be included.
Exclusion criteria
Exclusion criteria included; previous surgery to the AC joint or rotator cuff, diminished rotator cuff strength or positive impingement signs, diminished passive glenohumeral movement, and patients with a known allergy to local anaesthetics or previous adverse reactions to corticosteroid injections elsewhere in the body
Outcome results
None listed