Rent Test

Original Editor - Ron Bucholtz

Top Contributors - Ron Bucholtz, Dan Rhon, Evan Thomas, Naomi O'Reilly and Claire Knott

Purpose

To test for the presence of rotator cuff tears.

Technique

Patient is seated with examiner standing behind patient. Have patient relax - palpate anterior margin of the acromion through the deltoid - while doing this grasp the patient's arm with the other hand at the elbow/forearm (patients elbow should be flexed to ~ 90 degrees) and bring into extension. Passively internally and externally rotate patients arm to palpate rotator cuff tendons. Presence of palpable or prominent eminence (Greater tuberosity) and/or rent (defect or 'sulcus')[1] is indicative of full-thickness tear. [2][3][4]
[5]

Evidence

Wolf and Agrawal[2] report Sensitivity and Specificity of 95.7% (.96[4]) and 96.8% (.97[4]) respectively with a positive predictive value of 95.7%, negative predictive value of 96.8% and a diagnostic accuracy of 96.3%. Cleland[4] calculates a +LR of 32.0 and -LR of .04.  Lyons and Tomlinson[3] reported Sn of 91% (.91) and Sp of 75% (.75).

References

  1. Dutton M. Orthopaedic Examination, Evaluation, and Intervention. New York: The McGraw-Hill Companies (2nd Ed.) 2008
  2. 2.0 2.1 Wolf EM & Agrawal V. Transdeltoid palpation (the rent test) in the diagnosis of rotator cuff tears. J Shoulder Elbow Surg. Sept/Oct 2001;10(5):470-473
  3. 3.0 3.1 Lyons AR & Tomlinson JE. Clinical Diagnosis of Tears of the Rotator Cuff. J Bone Joint Surg. May 1991;(74):404-405
  4. 4.0 4.1 4.2 4.3 Cleland J. Orthopaedic Clinical Examination: An Evidence-Based Approach for Physical Therapists. Philadelphia; Saunders, Elsevier: 2007
  5. Clinically Relevant Technologies, http://www.youtube.com/watch?v=YA6oasQWGFA, Accessed May 2011