Original article
Lag signs in the diagnosis of rotator cuff rupture1

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We assessed the relative value of lag signs for the evaluation of rotator cuff rupture in a prospective study of 100 consecutive painful shoulders with impingement syndrome, stages 1 to 3. Lag signs were compared with the Jobe and lift-off signs. Three tests were designed to assess the main components of the rotator cuff: the external rotation lag sign (ERLS) for the supraspinatus and the infraspinatus tendons, the drop sign for the infraspinatus, and the internal rotation lag sign (IRLS) for the subscapularis tendon. For assessment of the supraspinatus and infraspinatus the ERLS was less sensitive but more specific than the Jobe sign. The drop sign was the least sensitive but was as specific as the ERLS. Partial ruptures of the supraspinatus remained concealed to the ERLS. For assessment of the subscapularis the IRLS was as specific but more sensitive than the lift-off sign. Partial ruptures of the subscapularis tendon could be missed by the lift-off sign but were detected by the IRLS. The magnitude of the lag correlated with the size of the rupture for both the ERLS and the IRLS. Clinical testing for lag signs was efficient, reproducible, and reliable. In patients with little or no restriction of motion it enhanced the accuracy of clinical diagnosis in rotator cuff lesions.

References (8)

  • ColtonT

    Statistics in medicine

  • GerberC et al.

    Isolated tears of the subscapularis muscle. Clinical features in sixteen cases

    J Bone Joint Surg Br

    (1991)
  • HowellSM et al.

    Clarification of the role of the supraspinatus muscle in shoulder function

    J Bone Joint Surg Am

    (1986)
  • JobeFW et al.

    Delineation of diagnostic criteria and a rehabilitation program for rotator cuff injuries

    Am J Sports Med

    (1982)
There are more references available in the full text version of this article.

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    The study group included 12 consecutive, prospectively enrolled, subjects with AC. The diagnosis, which was made by the senior author (C.A.) after clinical and radiologic examination, was based on a reduction in both active and passive range of motion (ROM) of the shoulder, evaluated in the sitting and supine positions; no strength reduction in intra-extrarotation; exclusion of the posterosuperior18,24,27,29,35,42 and anterior1,11,41 rotator cuff tendon tears; a radiographic evaluation, that is, true anteroposterior view (with the central ray tangential to the glenoid surface) and a Velpeau axillary view (with the patient's arm held in internal rotation, the ray is superior to inferior and the patient leaning backward); and an MRI of the involved shoulder. All the patients were evaluated between November 15, 2020, and January 15, 2021, at the shoulder surgery unit at our hospital, and all reported shoulder stiffness and pain arising after COVID-19, with no apparent cause.

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1

Dr. Lambert is supported by grants from AO International, Davos, Switzerland, The Wellington Foundation Fund, London, U.K., The St. Mary's Special Trustees Fund, London, U.K., The Ethicon Foundation Fund of the Royal College of Surgeons of England. London, U.K.

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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