Test library › Shoulder & upper arm
Clinical tests for subscapularis tear, compared
A tear in the subscapularis, the rotator cuff tendon at the front of the shoulder that turns the arm inwards (internal rotation).
The 4 tests in the library for subscapularis tear, side by side, each with the published accuracy figures that exist for it. Click a test for what each result means, any caution, and the source.
| Test | Sensitivity | Specificity | LR+ | LR− | Verdict |
|---|---|---|---|---|---|
| Bear-hug test (website only) | 55% | 94% | 9.2 | 0.48 | Best used to rule in |
| Belly-off sign (website only) | 87% | 91% | 10.1 | 0.15 | Treat with caution |
| Belly-press test | 28% | 87% | 2.2 | 0.83 | A weak test on its own |
| Lift-off test | 33% | 94% | 5.5 | 0.71 | Best used to rule in |
Reading the table
A high LR+ makes a positive result useful for ruling the condition in; a low LR− makes a negative result useful for ruling it out. A test can be good in one direction and weak in the other, and the figures come from different studies and patient groups, so compare them with care.
Tests for the same problem are rarely independent, so a second positive adds much less than its own figure suggests. Do not multiply their figures together. Where a combination has been tested as a cluster or a decision rule, its published result is given on that cluster’s own page.
To turn a figure into a probability for your patient, use the probability calculator.
Get the book for the shoulder questions that matter: neck or shoulder, a painful cuff or a torn one, and an unstable joint or the labrum
This page gives the published figures. For the tests in it that are in the book, Rule It In, Rule It Out adds how to do each test, what counts as positive, how to read the result, and, where studied, whether combining tests helps.
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