RESUMEN

OBJECTIVE: The aim of this study is to evaluate the internal validity of a clinical test for the early diagnosis of shoulder adhesive capsulitis, called the Distension Test in Passive External Rotation (DTPER). MATERIAL AND METHOD: The DTPER is performed with the patient standing up, the arm adducted, and the elbow bent at 90°. From this position, a smooth passive external rotation is started, the affected arm being supporting at the wrist with one hand of the examiner and the other maintaining the adducted elbow until the maximum painless point of the rotation is reached. From this point of maximum external rotation with the arm in adduction and with no pain, an abrupt distension movement is made, increasing the external rotation, causing pain in the shoulder if the test is positive. This term was performed on a group of patients with shoulder pain of many origins, in order to analyse the predictive values, sensitivity, specificity, and the likelihood ratio. RESULTS: The DTPER showed a sensitivity of 100% (95% CI; 91.8 to 100%) and a specificity of 90% (95% CI; 82.4 to 94.8%). The positive predictive value was 0.62 and a likelihood ratio of 10.22 (95% CI; 5.5 to 19.01). False positives were only found in patients with subscapular tendinopathies or glenohumeral arthrosis. DISCUSSION: The DTPER has a high sensitivity for the diagnosis of adhesive capsulitis, and is excluded when it is practically negative. False positives can easily be identified if there is external rotation with no limits (subscapular tendinopathy) or with a simple shoulder X-ray (glenohumeral arthrosis).

Asunto(s)

Bursitis/diagnóstico , Rango del Movimiento Articular , Rotación , Articulación del Hombro/fisiopatología , Adulto , Anciano , Bursitis/fisiopatología , Diagnóstico Precoz , Reacciones Falso Positivas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad

RESUMEN

The magnetization of the sigma-phase Fe(0.53)Cr(0.47) and Fe(0.52)V(0.48) alloys was studied as a function of temperature and field. The experiments show that both materials behave magnetically as re-entrant spin glass systems. Field versus temperature diagrams were obtained where the locations of the paramagnetic phase, the intermediate ferromagnetic-like phase and the spin glass fundamental state were displayed. These diagrams are in qualitative agreement with the predictions of the mean field theory for the interplay between the ferromagnetic and spin glass orderings. The critical phenomenology near the para-ferromagnetic transition could be investigated. It was found that the paramagnetic susceptibility is quite well described by the extended scaling scheme, where the reduced temperature is written as τ = (T - T(c))/T. The value obtained for the susceptibility critical exponent γ is intermediate between the prediction of the 3D Heisenberg universality class and the large values observed in spin glasses, as previously found in other re-entrant systems. The data do not confirm the validity of the extended scaling in the ferromagnetic-like phase. Using either the conventional or extended scaling protocols, the exponents ß and δ were found to have values close to those reported for spin glass transitions. Despite the relevance of disorder and the anomalous values determined for ß, γ and δ, the Widom scaling relation holds as an equality.