【摘要】 目的探讨Hug-up试验在老年冈上肌腱损伤诊断中的价值。方法回顾性分析2019年3月11日至2020年6月10日以肩袖损伤为诊断入院行肩关节镜手术治疗的老年患者90例,分别行物理检查:Hug-up试验、改良Hug-up试验、Jobe试验、坠肩试验、0°外展抗阻试验。由专人记录结果,以术中关节镜检查结果为金标准,通过对比分析Hug-up试验对老年冈上肌腱部分损伤的灵敏度、特异性、准确度等进行综合性探讨。结果经关节镜检查证实,90例患者中确诊为冈上肌腱全层断裂70例,部分断裂9例,其他肩袖组织损伤或合并伤11例,冻结肩或合并有冻结肩症状61例。灵敏度:Hug-up试验=0°位外展抗阻试验>改良Hug-up试验> Jobe试验>坠肩试验,特异度:改良Hug-up试验=Hug-up试验>坠肩试验> 0°位外展抗阻试验> Jobe试验,准确度:0°位外展抗阻试验> Hug-up试验>改良Hug-up试验> Jobe试验>坠肩试验。结论Hug-up试验对于老年冈上肌腱损伤敏感性、特异性均较高,在合并喙肩韧带损伤或炎症及冈下肌小圆肌病变的情况下容易出现假阳性,但相较于其他体格检查方法,其易于操作,且位置固定,患者容易配合,检查结果在患者间及检查者间的可重复性高、误差率低,对于门诊老年冈上肌腱损伤的快速诊断具有重要价值。更多还原

【Abstract】 Background Rotator cuff injury is one of the most important causes of shoulder pain and dysfunction,and the incidence in the elderly is increasing year by year.How to diagnose supraspinatus tendon injury easily,quickly and accurately in the outpatient and emergency department is an urgent need for physicians.At present,the commonly used physical examination methods include the Jobe test,the drop arm sign,and the 0 degree abduction resistance test.These special examination methods require the patient to accurately make a special position and cooperate with the examiner to complete the physical examination to make an accurate judgment.For elderly patients,it is difficult to accurately complete the above physical examination in clinical practice due to the influence of various factors,such as poor understanding or physical coordination.In recent years,some scholars have proposed the Hug-up test which has a relatively fixed body position.Physician operations are relatively simple and reproducible.Therefore,we compared the Hug-up test and the modified Hug-up test with other common physical examination methods for elderly patients with supraspinatus tendon injury,and comprehensively evaluated the value of the Hug-up test in the diagnosis of elderly supraspinatus tendon injury for reference of clinicians.Objective To explore the value of Hug-up test in the diagnosis of supraspinatus tendon injury in the elderly.Methods From March 11,2019 to June 10,2020,a retrospective analysis of 90 elderly patients who were diagnosed with rotator cuff injury and received shoulder arthroscopic surgery underwent physical examinations:Hug-up test and modified Hug-up test,Jobe test,drop arm test,0 degree abduction resistance test.The results were recorded by a dedicated physician,and the intraoperative arthroscopy results were used as the gold standard.The sensitivity,specificity,and accuracy of partial injury of the elderly supraspinatus tendon were comprehensively explored through comparative analysis of the Hug-up test.Results It was confirmed by arthroscopy that 70 of the 90 patients were diagnosed with a full-thickness rupture of the supraspinatus tendon,9 cases were partially ruptured,11 cases of other rotator cuff tissue injuries or combined injuries,and 61 cases of frozen shoulder or combined with frozen shoulder symptoms.Sensitivity:Hug-up test=0 degree abduction resistance test> modified Hug-up test> Jobe test> drop arm test.Specificity:modified Hug-up test=Hug-up test> drop arm test> 0 degree abduction resistance test> Jobe test.Accuracy:0 degree abduction resistance test> Hug-up test> modified Hug-up test> Jobe test> drop arm test.Conclusion The Hug-up test has high sensitivity and specificity for the diagnosis of elderly supraspinatus tendon injuries.It is prone to false positives when combined with coracoclavicular ligament injury or inflammation and infraspinatus and teres minor muscle lesions.However,compared to other cases,the physical examination method is easy to operate with fixed position,which is easy for patients to cooperate with high reproducibility of examination results between patients and examiners and low error rate.It is of great value for the rapid diagnosis of outpatient senile supraspinatus tendon injuries.更多还原