Terminology and diagnostic criteria used in studies investigating patients with subacromial pain syndrome from 1972 to 2019: a scoping review.

INTRODUCTION: There is no recognised terminology, nor diagnostic criteria, for patients with subacromial pain syndrome (SAPS). This is likely to cause heterogeneity across patient populations. This could be a driver of misconceptions and misinterpretations of scientific results. We aimed to map the literature regarding terminology and diagnostic criteria used in studies investigating SAPS. MATERIALS AND METHODS: Electronic databases were searched from inception to June 2020. Original peer-reviewed studies investigating SAPS (also known as subacromial impingement or rotator cuff tendinopathy/impingement/syndrome) were eligible for inclusion. Studies containing secondary analyses, reviews, pilot studies and studies with less than 10 participants were excluded. RESULTS: 11 056 records were identified. 902 were retrieved for full-text screening. 535 were included. 27 unique terms were identified. Mechanistic terms containing 'impingement' are used less than before, while SAPS is used increasingly. For diagnoses, combinations of Hawkin's, Neer's, Jobe's, painful arc, injection test and isometric shoulder strength tests were the most often used, though this varied considerably across studies. 146 different test combinations were identified. 9% of the studies included patients with full-thickness supraspinatus tears and 46% did not. CONCLUSION: The terminology varied considerably across studies and time. The diagnostic criteria were often based on a cluster of physical examination tests. Imaging was primarily used to exclude other pathologies but was not used consistently. Patients with full-thickness supraspinatus tears were most often excluded. In summary, studies investigating SAPS are heterogeneous to an extent that makes it difficult, and often impossible, to compare studies.

Interrater reliability of subacromial ultrasound measures in the hands of novice sonographers.

INTRODUCTION: Ultrasound measures of subacromial structures are reliable in the hands of experienced sonographers, but it remains unknown if inexperienced clinicians can achieve a satisfactory level of interrater reliability. The aim was to investigate if standardised subacromial ultrasound measures are reliable in the hands of novice sonographers. METHODS: Two novice sonographers performed standardised ultrasound measures on patients diagnosed with subacromial pain syndrome and asymptomatic shoulders. The measures were: supraspinatus tendon thickness (SUPRA), subacromial bursa thickness (SASD), acromio-humeral distance (AHD) and dynamic impingement (DI). Reliability and agreement were evaluated by intraclass correlation coefficient (ICC (2.1)), standard error of measurement, minimal detectable change, 95% limits of agreement, Bland-Altman plots and Cohen's unweighted κ. RESULTS: Twenty-eight patients were recruited (28 symptomatic and 20 asymptomatic shoulders). The ICC of SUPRA ranged from 0.73 to 0.77. The ICC of SASD ranged from 0.41 to 0.88 and AHD from 0.68 to 0.72. Cohen's κ of DI in symptomatic shoulders was 0.29. CONCLUSION: The interrater reliability of novice sonographers was found to be moderate to good when assessing SUPRA and AHD. For SASD and DI, the reliability ranged from poor to good. No significant differences in SUPRA and SASD thickness were found between symptomatic and asymptomatic shoulders. FUNDING: None. TRIAL REGISTRATION: Not relevant.