کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4075303 1267035 2009 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The active elevation lag sign and the triangle sign: New clinical signs of trapezius palsy
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
پیش نمایش صفحه اول مقاله
The active elevation lag sign and the triangle sign: New clinical signs of trapezius palsy
چکیده انگلیسی

BackgroundSpinal accessory nerve palsy causing trapezius dysfunction can lead to significant disability. Diagnosis is frequently delayed or inaccurate leading to inappropriate treatment.MethodsWe describe new clinical signs for trapezius muscle dysfunction and palsy, and accessory nerve palsy, viz. The Active Elevation Lag sign and the Triangle sign. These signs help to differentiate between scapular winging due to trapezius dysfunction and that due to serratus anterior dysfunction. The signs are based on the principle that the deficiency of trapezius function causes an `active forward elevation lag' with compensatory spinal hyperextension, and lead to the Triangle sign in the prone position, whereas no such lag is found in patients with pure serratus anterior dysfunction. Video recordings of clinical examination of 10 patients, 5 with isolated spinal accessory nerve palsy and 5 with long thoracic nerve palsy (confirmed by neurophysiology studies) were blinded and reviewed by 8 assessors.ResultsOf the total of 80 readings, 100% sensitivity and 95% specificity were found, in correlation with the diagnosis confirmed by neurophysiology studies, with positive predictive value of 95% and negative predictive value of 100%.ConclusionThese are simple clinical signs, easy to perform which are useful in diagnosing trapezius weakness in clinical practice.Level of evidenceLevel 2-1; Evidence obtained from well-designed controlled trials without randomization.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Shoulder and Elbow Surgery - Volume 18, Issue 4, July–August 2009, Pages 573–576
نویسندگان
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