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Arm Squeeze Test: a new clinical test to distinguish neck from shoulder pain

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Abstract

Purpose

Objective of this study is to evaluate the diagnostic values of the Arm Squeeze Test. The test consists in squeezing the middle third of the upper arm.

Methods

1,567 patients were included in this study. Diagnosis of cervical nerve root compression or shoulder disease was clinically formulated and confirmed with imaging before performing test. 350 healthy volunteers were recruited as controls. The test was positive when score on a VAS Scale was 3 points or higher on squeezing the middle third of the upper arm compared to acromioclavicular (AC) joint and anterolateral-subacromial area.

Results

Patients were subdivided as follows: 903 with rotator cuff tear, 155 with shoulder adhesive capsulitis, 101 with AC joint arthropathy, 55 with calcifying tendonitis, and 48 affected by glenohumeral arthritis. The study sample included 305 patients with cervical nerve root compression from C5 to T1 with shoulder radicular pain. The test was positive in 295/305 (96.7 %) of patients with cervical nerve root compression, compared to 35/903 (3.87 %), 3/155 (1.93 %), 0/101 (0 %), 1/55 (1.81 %) and 4/48 (8.33 %) of those with rotator cuff tear, adhesive capsulitis, AC arthropathy, calcifying tendonitis and glenohumeral arthritis, respectively. A positive result was obtained in 14/350 asymptomatic subjects (4 %). If patients with cervical nerve root compression were compared to controls and patients with shoulder diseases, the test had sensitivity of 0.96 and specificity from 0.91 to 1.

Conclusions

The Arm Squeeze Test may be useful to distinguish cervical nerve root compression from shoulder disease in case of doubtful diagnosis. A positive result to this test may lead to cervical etiology of the shoulder pain.

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References

  1. Borenstein DG, Wiesel SW, Boden SD (1996) Neck Pain: Medical Diagnosis and Comprehensive Management. Saunders, Philadelphia

    Google Scholar 

  2. Katz JS, Saperstein DS, Wolfe G, Nations SP, Alkhersam H, Amato AA, Barohon RJ (2001) Cervicobrachial involvement in diabetic radiculoplexopathy. Muscle Nerve 24:794–798. doi:10.1002/mus.1071

    Article  PubMed  CAS  Google Scholar 

  3. McFarland EG (2006) Examination of the shoulder. Thieme, New York

    Google Scholar 

  4. Gorski JM, Schwartz LH (2003) Shoulder impingement presenting as neck pain. J Bone Joint Surg 85:635–638

    PubMed  Google Scholar 

  5. Mamula CJ, Erhard RE, Piva SR (2005) Cervical radiculopathy or Parsonage-Turner syndrome: differential diagnosis of a patient with neck and upper extremity symptoms. J Orthop Sports Phys Ther 35:659–664

    PubMed  Google Scholar 

  6. Tsiptsios I, Fotiou F, Sitzoglou K, Fountoulakis KN (2001) Neurophysiological investigation of cervical spondylosis. Electromyogr Clin Neurophysiol 4:305–313

    Google Scholar 

  7. Reider B (2001) The orthopaedic physical examination. W. B. Saunders Company, Philadelphia

    Google Scholar 

  8. Selvaratnam PJ, Matyas TA, Glasgow EF (1994) Noninvasive discrimination of brachial 217 plexus involvement in upper limb pain. Spine 19:26–33

    Article  PubMed  CAS  Google Scholar 

  9. Yung E, Asavasopon S, Godges J (2010) Screening for head, neck, and shoulder pathology in patients with upper extremity signs and symptoms. J Hand Ther 23:173–186. doi:10.1016/j.jht.2009.11.004

    Article  PubMed  Google Scholar 

  10. Rockwood CA (2009) The shoulder, 4th edn. W. B. Saunders, Philadelphia

    Google Scholar 

  11. Sackett DL, Haynes RB (2002) The architecture of diagnostic research. BMJ 324:539–541

    Article  PubMed  CAS  Google Scholar 

  12. Landis JR, Koch GC (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  PubMed  CAS  Google Scholar 

  13. Samilson RL, Prieto V (1983) Dislocation arthropathy of the shoulder. J Bone Joint Surg Am 65:456–460

    PubMed  CAS  Google Scholar 

  14. Pateder DB, Berg JH, Thal R (2009) Neck and shoulder pain: differentiating cervical spine pathology from shoulder pathology. J Surg Orthop Adv 18:170–174

    PubMed  Google Scholar 

  15. Macnab I, McCulloch J (1994) Neck ache and Shoulder pain. Williams and Wilkins, Baltimore

    Google Scholar 

  16. Nordin M, Carragee EJ, Hogg-Johnson S, Weiner SS, Hurwitz EL, Peloso PM, Guzman J, van der Velde G, Carroll LJ, Holm LW, Côté P, Cassidy JD, Haldeman S (2008) Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000–2010 Task Force on neck pain and its associated disorders. Spine 33(4 Suppl):S101–S122

    Article  PubMed  Google Scholar 

  17. Wainner RS, Frizt JM, Irrang JJ, Boninger ML, Delitto A, Allison S (2003) Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine 28:52–62

    Article  PubMed  Google Scholar 

  18. Hoppenfield S (1976) Examinations of the spine and extremities. Prentice-Hall, New York

    Google Scholar 

  19. Gumina S, Carbone S, Arceri V, Rita A, Vestri AM, Postacchini F (2009) The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain. BMC Musculoskelet Disord 10:157–165. doi:10.1186/1471-2474-10-157

    Article  PubMed  Google Scholar 

  20. Rubinstein SM, Pool JJ, van Tulder MW, Riphagen II, de Vet HC (2007) A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J 16:307–319. doi:10.1007/s00586-006-0225-6

    Article  PubMed  Google Scholar 

  21. Tong HC, Haig AJ, Yamakawa K (2002) The spurling test and cervical radiculopathy. Spine 27:156–159

    Article  PubMed  Google Scholar 

  22. Reilly PA, Littlejohn GO (1990) The brachial plexus tension test of Elvey. Br J Rheumatol 29:234–235

    Article  PubMed  CAS  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Stefano Carbone.

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Gumina, S., Carbone, S., Albino, P. et al. Arm Squeeze Test: a new clinical test to distinguish neck from shoulder pain. Eur Spine J 22, 1558–1563 (2013). https://doi.org/10.1007/s00586-013-2788-3

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  • DOI: https://doi.org/10.1007/s00586-013-2788-3

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