[Anatomy and diagnostics of subscapularis tendon lesions].

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Abstract

[Indexed for MEDLINE] 10. Methods Protoc. 2025 Nov 3;8(6):133. doi: 10.3390/mps8060133. Functional Outcomes After Imaging- and Orthopedic Test-Guided Evaluation of Shoulder Disorders: Systematic Review and Meta-Analysis. García-de-Pereda-Notario CM(1)(2), Palomeque-Del-Cerro L(3)(4), García-Mata R(5), Arráez-Aybar LA(1)(2). Author information: (1)Department of Anatomy and Embryology, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain. (2)UCM Research Group No. 920202, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain. (3)Department of Physiotherapy, Faculty of Nursing and Physiotherapy "Salus Infirmorum", Universidad Pontificia de Salamanca, 28015 Madrid, Spain. (4)Escuela de Osteopatía de Madrid, 28033 Madrid, Spain. (5)Research Support, UCM IT Services, 28040 Madrid, Spain. BACKGROUND: Shoulder soft tissue disorders, such as rotator cuff tears and subacromial impingement, are among the most common causes of musculoskeletal disability. Both physical examination tests and imaging techniques are routinely used in clinical settings; however, their respective contributions to patient outcomes and their potential complementarity remain underexplored. METHODS: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Controlled clinical studies comparing pre- and post-intervention outcomes in adults with suspected or confirmed shoulder soft tissue pathology were included. Two groups were analyzed: studies using musculoskeletal imaging (ultrasound or MRI) and studies applying orthopedic physical examination tests (e.g., Neer, Hawkins, and Jobe). Functional outcomes were converted into standardized mean differences (SMDs) and synthesized using a random-effects model. Heterogeneity was quantified using the I2 statistic. RESULTS: In total, 11 studies met the inclusion criteria (n = 6 imaging, n = 5 orthopedic tests). Imaging-based studies showed a pooled SMD of 4.85 (95% CI: 2.77-6.93), indicating substantial clinical improvement. Orthopedic test-based studies yielded a pooled SMD of 2.34 (95% CI: 1.27-3.41). Heterogeneity was high across both groups (I2 > 90%). CONCLUSIONS: Imaging was associated with a larger overall clinical effect, while orthopedic tests provided functional insight valuable for screening and monitoring. These findings support the complementary use of both strategies to enhance diagnostic accuracy and treatment planning in shoulder care. DOI: 10.3390/mps8060133 PMCID: PMC12641838