(English) Episode 274-Most shoulder tests are coin flips

This systematic review and meta-analysis updates prior research on the diagnostic accuracy of shoulder physical examination (ShPE) tests. After analyzing 32 new studies alongside historical data, the authors found that no single clinical test can definitively confirm a specific shoulder pathology. While specific maneuvers like the apprehension and surprise tests show promise for identifying instability, many common tests for SLAP lesions and impingement lack sufficient reliability when used in isolation. The report identifies significant concerns regarding bias and inconsistent methodology in many existing studies, particularly concerning the use of non-gold-standard reference criteria. Consequently, the authors emphasize that clinicians should rely on a comprehensive clinical history and combinations of tests rather than individual findings. Ultimately, the source highlights a critical need for large-scale, high-quality prospective research to refine the diagnostic value of shoulder examinations.(Hegedus EJ, Goode AP, Cook CE, Michener L, Myer CA, Myer DM, et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med [Internet]. 2012;46(14):964–78. Available from: http://dx.doi.org/10.1136/bjsports-2012-091066)