The diagnostic value of physical examination tests in adhesive capsulitis: a systematic review.
Marc Schiltz, Lisa Goudman, Maarten Moens and 2 others
PMID 37737049WHAT IT FOUND
No single physical exam test reliably diagnoses adhesive capsulitis.
Coracoid Pain Test and Distension Test showed high accuracy in initial studies but results were inconsistent or unreproduced, leaving clinicians without a definitive bedside diagnostic tool.
Key findings
01The systematic review could not identify a single clinical diagnostic test with the best accuracy due to heterogeneity in tests and inconsistent results.
02Initial high sensitivity and specificity values for tests like the Coracoid Pain Test were not reproduced in subsequent publications, and the overall methodological quality of included studies was fair.
03The Distension Test in Passive External Rotation and an instrument-assisted Coracoid Pain Test using an affected-unaffected shoulder comparison were suggested as promising for further research.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only nine studies were included, and most tests were evaluated in only one study, preventing meta-analysis. The methodological quality of the included studies was rated as "fair", with only two studies rated as "good". Diagnostic criteria for adhesive capsulitis varied significantly across the included studies, introducing recruitment bias. High diagnostic accuracy values reported in single studies were not reproduced in subsequent research. Cut-off values for many tests were chosen arbitrarily rather than determined by statistical methods like ROC curves.
Declared interests
The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
The easy way to misread this
Do not assume the Coracoid Pain Test or Distension Test are definitive diagnostic tools. Although initial studies reported very high sensitivity and specificity, these results were inconsistent across studies and not reproduced in subsequent research, meaning no single physical exam test is currently validated for diagnosing adhesive capsulitis.