筋腱疾患
当院での腱板断裂診断テスト
（ MRI 診断との比較評価）
（ MRI 診断との比較評価）
2009 年 33 巻 3 号 p. 777-780
詳細
2009 年 33 巻 3 号 p. 777-780
Rotator cuffs possess 2 functions. They function as action-making muscles and also provide stabilization. At present, most diagnostic tests for rotator cuffs are designed to assess individual muscles as action- making muscles, and there are hardly any tests to evaluate stabilization. This time, we performed diagnostic tests focused on the stabilization function that maintains centripetal positions, and investigated sensitivity and specificity by comparing them with MRI-based diagnoses. Of the patients who visited our hospital complaining of shoulder pain, 177 shoulders for which cervical vertebralcauses had been clearly negated using MRI imagings were subjected to abduction tests of shoulder joints on the scapular axis (1st procedure), and flexion tests with horizontal flexion at 120 degrees: diagnostic tests performed at our hospital (2nd procedure). Comparisons were made between these tests for detection rates of rotator cuff tears (positive when MMT was 3 or less) and for muscular strength at positions for each test using power track II. Positive and negative results obtained in the second procedure were compared with MRI-based diagnosis, and the sensitivity and specificity of the 2nd procedure were studied. The positive rate for rotator cuff tears was higher in the 2nd procedure and muscular strength had also decreased in the position in the 2nd procedure according to the test using power track II in patients with rotator cuff tears. These sensitivity and specificity of the 2nd procedure were 71.4% and 90.8% respectively. Anterior parts of subscapularis muscle tendons seemed to be relaxed in the MRI images in the 2nd procedure, and scapular axes and rotation axes of humeri did not agree with images obtained in the 1st procedure either. It is thought that the 2nd procedure is an effective test method for diagnosing rotator cuff tears considering sensitivity and specificity as well as the concept force couple, suggesting that it is difficult to take the centripetal position in the 2nd procedure.
