Dynamic ultrasound tests for antero-superior shoulder impingement syndrome: An inter-examiner reliability study

Abstract Background The antero-superior impingement syndrome of the shoulder is a condition that is frequently encountered in musculoskeletal practice. Clinical examination tests used to diagnose this pathology are sensitive but not specific. Dynamic ultrasound is of great potential value because this diagnostic tool can be used in addition to the physical examination; it can view the joint in motion and demonstrate impingement. The specificity of Antero-Superior Impingement Syndrome diagnosis may be improved by ultrasonography; however, it is necessary to ascertain that dynamic ultrasound has good reliability in this setting. This study was designed to determine the degree of agreement between examiners for the commonly used tests for the antero-superior impingement syndrome. Methodology Forty-one patients with chronic shoulder pain (>2 months) selected consecutively in private chiropractic consultation. These patients were referred within a week to two experienced radiologists who evaluated the positive or negative nature of two dynamic ultrasound tests: the abduction impingement test and the Hawkins–Kennedy test. Results The Cohen's kappa value was moderate for the abduction impingement test (κ = 0.52, P < 0.05) and poor for the Hawkins–Kennedy test (κ = 0.36, P < 0.05). Conclusion The ultrasound abduction impingement test is reliable when performed in a standardized manner and by experienced practitioners.