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A positive result on both the Paxinos test and bone scan ruled in a diagnosis of acromioclavicular joint pain

Clinical impact ratings GP/FP/Primary care Surgery

Key Words: acromioclavicular joint • shoulder pain

The first 150 words of the full text of this article appear below.

METHODS
Design: blinded comparison of the clinical and imaging tests with results of the ACJ infiltration test as the reference standard.

Setting: a university hospital in Sydney, New South Wales, Australia.

Patients: 38 patients (mean age 44 y, 58% women) who had shoulder pain that was mapped within an area bounded by the midpart of the clavicle and the deltoid insertion. Exclusion criteria included previous clavicular or ACJ surgery, clavicular fracture, previous or known allergies to lidocaine or radiopaque contrast medium, and pregnancy.

Description of tests: clinical tests included examination (by a physician) for tenderness of the ACJ, and the Paxinos and O’Brien signs with the results declared as positive (for ACJ pain) or negative. Imaging tests included plain radiographs, magnetic resonance imaging, and bone scanning. A radiologist with expertise in musculoskeletal conditions ranked an image of the ACJ as normal or abnormal.

Diagnostic standard: patients received an ACJ infiltration of . . . [Full text of this article]

Michael Yelland, MBBS, FRACGP

University of Queensland
Brisbane, Queensland, Australia