Validity of Cyriax’s Functional Examination for Diagnosing Shoulder Pain: A Diagnostic Accuracy Study

  • Ying-Chen Kuo
    Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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  • Lin-Fen Hsieh
    Corresponding author: Lin-Fen Hsieh, MD, B1F., No. 95, Wen Chang Road, Shih Lin District, Taipei City, Taipei 111, Taiwan. Tel.: +886 2 28332211 ext. 2538.
    Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

    School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
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      The purpose of this study was to compare the diagnostic accuracy of lesion localization between Cyriax’s functional examination and ultrasonography in participants with and without shoulder pain.


      A total of 206 adults aged 20 years and older with or without shoulder pain were included. All participants received Cyriax’s functional examination by the first blinded physiatrist. Within a week, ultrasonography was performed by another blinded specialist. The diagnoses made by both methods, respectively, were compared finally. Sensitivity, specificity, and positive and negative predictive values were evaluated for the diagnosis of shoulder lesions between Cyriax’s functional examination and ultrasonography.


      There was no significant difference between the 2 groups regarding age, sex, and body mass index. Moderate to high sensitivity (74.1%, 76.5%, and 66.7%) and high specificity (93.0%, 99.5%, and 99.0%) were in supraspinatus, subscapularis, and infraspinatus lesions, respectively. For the subacromial-subdeltoid bursitis, high sensitivity (90.4%) and moderate to high specificity (70.3%) was found. In contrast, low sensitivity (15.0%) and high specificity (100.0%) were found in the biceps lesions.


      In this study, we found that Cyriax’s functional examination had high sensitivity in detecting subacromial-subdeltoid bursitis and high specificity in rotator cuff lesion.

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