Rotator cuff injury is one of the most important causes of shoulder pain and dysfunction, and the incidence in the elderly is increasing year by year. How to diagnose supraspinatus tendon injury easily, quickly and accurately in the outpatient and emergency department is an urgent need for physicians. At present, the commonly used physical examination methods include the Jobe test, the drop arm sign, and the 0 degree abduction resistance test. These special examination methods require the patient to accurately make a special position and cooperate with the examiner to complete the physical examination to make an accurate judgment. For elderly patients, it is difficult to accurately complete the above physical examination in clinical practice due to the influence of various factors, such as poor understanding or physical coordination. In recent years, some scholars have proposed the Hug-up test which has a relatively fixed body position. Physician operations are relatively simple and reproducible. Therefore, we compared the Hug-up test and the modified Hug-up test with other common physical examination methods for elderly patients with supraspinatus tendon injury, and comprehensively evaluated the value of the Hug-up test in the diagnosis of elderly supraspinatus tendon injury for reference of clinicians.

To explore the value of Hug-up test in the diagnosis of supraspinatus tendon injury in the elderly.

From March 11, 2019 to June 10, 2020, a retrospective analysis of 90 elderly patients who were diagnosed with rotator cuff injury and received shoulder arthroscopic surgery underwent physical examinations: Hug-up test and modified Hug-up test, Jobe test, drop arm test, 0 degree abduction resistance test. The results were recorded by a dedicated physician, and the intraoperative arthroscopy results were used as the gold standard. The sensitivity, specificity, and accuracy of partial injury of the elderly supraspinatus tendon were comprehensively explored through comparative analysis of the Hug-up test.

It was confirmed by arthroscopy that 70 of the 90 patients were diagnosed with a full-thickness rupture of the supraspinatus tendon, 9 cases were partially ruptured, 11 cases of other rotator cuff tissue injuries or combined injuries, and 61 cases of frozen shoulder or combined with frozen shoulder symptoms. Sensitivity: Hug-up test = 0 degree abduction resistance test>modified Hug-up test > Jobe test > drop arm test. Specificity: modified Hug-up test = Hug-up test>drop arm test>0 degree abduction resistance test > Jobe test. Accuracy: 0 degree abduction resistance test > Hug-up test > modified Hug-up test > Jobe test > drop arm test.

The Hug-up test has high sensitivity and specificity for the diagnosis of elderly supraspinatus tendon injuries. It is prone to false positives when combined with coracoclavicular ligament injury or inflammation and infraspinatus and teres minor muscle lesions. However, compared to other cases, the physical examination method is easy to operate with fixed position, which is easy for patients to cooperate with high reproducibility of examination results between patients and examiners and low error rate. It is of great value for the rapid diagnosis of outpatient senile supraspinatus tendon injuries.