The anatomical basis for clinical tests assessing musculoskeletal function of the shoulder

Abstract

A large number of clinical tests have been reported to assess the musculoskeletal integrity of the shoulder; however, for some of these tests, diagnostic accuracy is poor. Poor diagnostic accuracy may be related to a lack of understanding of the anatomical basis of the test. We conducted a systematic review of the relevant literature to ascertain whether an anatomical basis had been established for 34 common clinical tests for shoulder pathology. Searching of electronic databases yielded 11 papers that had reported on the anatomical basis for a total of six of the 34 clinical tests. Four of these tests had evidence from more than one study of a valid anatomical basis, but only two tests provided consensus evidence that supported the anatomical basis provided by the test developer. The lack of evidence about the anatomical validity of common clinical tests for shoulder function may explain the poor diagnostic accuracy of many of these tests. Further research into anatomical validity of tests may assist in the development of clinical tests of musculoskeletal integrity with improved diagnostic accuracy.

Keywords:

• ANATOMICAL BASIS
• CLINICAL TESTS
• SHOULDER