AC Joint Pain Cluster of Signs & Symptoms

The Cluster contains the following items:

1. Repetitive mechanism of pain onset
2. Absence of referred pain below the elbow
3. Thickened or swollen AC joint
4. Absence of typical pain provocation during passive glenohumeral abduction
5. Absence of typical pain provocation during passive glenohumeral external rotation in 90° abduction

 

Outcome:

• Pain referral below the elbow → Rule out AC J
• 0-1 positive tests → Rule Out ACJ
• 2 positive tests → ACJ pain unlikely
• 3 positive tests → ACJ pain more likely
• 4 or more positive tests → ACJ pain very likely

 

Study	Reliability	Sn	Sp	LR+	LR-
Cadogan et al. (2013): 1 or more +ve out of 5	NA	100	7	1.08	0
Cadogan et al. (2013): 2 or more +ve out of 5	NA	96	53	2.05	0.09
Cadogan et al. (2013): 3 or more +ve out of 5	NA	55	83	3.25	0.55
Cadogan et al. (2013): 4 or more +ve out of 5	NA	95	46	4.98	0.81
Comment: All traditional physical tests for the AC joint were found to be of weak diagnostic accuracy in the study