The lateral Jobe test: A more reliable method of diagnosing rotator cuff tears

PURPOSE: The most reliable clinical investigations to diagnose rotator cuff tears reported in the literature is a triad of weakness on resisted external rotation, pain on impingement, and weakness on supraspinatus testing, or a combination of two of the above in a patient over 60 years of age. We present a simple new clinical test “The lateral Jobe Test” and compare it to these combined tests. The lateral Jobe test is performed with the patient’s shoulder abducted 90° in the coronal plane and internally rotated so that with the elbows flexed 90° the fingers point inferiorly and thumbs medially. A positive test is pain or weakness on resisting an inferiorly directed force applied to the distal arms or an inability to perform the test. MATERIALS AND METHODS: A consecutive series of 175 patients undergoing shoulder arthroscopy were reviewed prospectively and examined by two independent orthopedic surgeons blinded to the diagnosis. The results of the clinical tests were validated against arthroscopic findings. RESULTS: The lateral Jobe test had a significantly higher sensitivity (81 vs. 58%) than the combined tests. The specificity of both was similar at 89 and 88%, respectively. CONSLUSION: The lateral Jobe test is a simple single test which can help in the clinical diagnosis of rotator cuff tears. LEVEL OF EVIDENCE: Level IIb