Which is more useful, the "full can test" or the "empty can test," in detecting the torn supraspinatus tendon?

Department of Orthopedic Surgery, Akita University School of Medicine, Japan.
The American Journal of Sports Medicine (Impact Factor: 4.36). 01/1999; 27(1):65-8. DOI: 10.1177/03635465990270011901
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The purpose of this study was to determine the clinical usefulness of the full can and empty can tests for determining the presence of a torn supraspinatus tendon. The two tests were performed in 143 shoulders of 136 consecutive patients. In each test, the muscle strength was determined by manual muscle testing, and the presence of pain during the maneuver was recorded. We interpreted the tests as positive when there was 1) pain, 2) muscle weakness, or 3) pain or muscle weakness or both. Shoulders were examined by high-resolution magnetic resonance imaging with 95% accuracy for full-thickness rotator cuff tears. There were 35 shoulders with full-thickness tears of the supraspinatus tendon. The accuracy of the tests was the greatest when muscle weakness was interpreted as indicating a torn supraspinatus tendon in both the full can test (75% accurate) and the empty can test (70% accurate). However, there was no significant difference between the accuracy of the tests when this criterion was used. Pain was observed in 62 shoulders (43%) during the full can test and in 71 shoulders (50%) during the empty can test, but the difference was not statistically significant. Muscle weakness should be interpreted as indicative of supraspinatus tendon tear. Using this indicator, both tests are equivalent in terms of accuracy, but considering pain provocation, the full can test may be more beneficial in the clinical setting.

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    • "Reinold et al. suggested that increased activity of the middle deltoid during the empty-can exercise relative to the full-can exercise may lead to a superiorly directed shear force of humeral head, which can cause pain or discomfort [18]. Additionally, Itoi et al. showed that both the empty-can and full-can tests are equivalent with regard to accurately diagnosing muscle weakness; however, when considering pain provocation, the full-can test may be more beneficial in the clinical setting [20]. Otis et al. showed that the upper subscapularis had a significant role in arm elevation in the scapular plane [15]. "
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    ABSTRACT: Background There has been much controversy over specific tests for diagnosis of supraspinatus tendon tear. The aim of this study was to evaluate the metabolic activity of the deltoid and rotator cuff muscles while maintaining the full-can and empty-can testing positions using 2-deoxy-2-[18¿F]fluoro-D-glucose (18¿F-FDG) positron emission tomography (PET)/computed tomography (CT).Methods Ten healthy volunteers without shoulder pain or diabetes mellitus participated in this study. Following FDG injection, both arms were maintained in either the empty-can or full-can position for 10 min. PET/CT was performed 40 min after injection. Maximum standardized uptake values (SUVs) were measured in the deltoid and rotator cuff muscles on axial PET images.ResultsThe middle deltoid exhibited the most significant increase in muscle activity at both testing positions. Additionally, a significant increase in muscle activity was observed in the middle deltoid compared with the supraspinatus (P¿<¿0.05) in the empty-can testing position. SUVs of the middle deltoid, supraspinatus, and subscapularis showed a significant increase in the empty-can testing position compared with the full-can testing position (P¿<¿0.05).Conclusions Significantly increased activity of the supraspinatus in conjunction with the middle deltoid and subscapularis after empty-can testing may result in decreased specificity of the empty-can test in detecting isolated supraspinatus activity. The full-can test, however, may be used to test the function of the supraspinatus with the least amount of surrounding middle deltoid and subscapularis activity.
    Journal of Orthopaedic Surgery and Research 10/2014; 9(1):85. DOI:10.1186/s13018-014-0085-4 · 1.39 Impact Factor
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    • "A tear of the supraspinatus tendon can be detected by the empty-can test (Fig. 8) [11] or full-can test (Fig. 9) [12]. The accuracy of the tests was the greatest when muscle weakness was interpreted as indicating a torn supraspinatus tendon in both the full-can test (75 % accurate) and the empty-can test (70 % accurate) [13]. "
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    ABSTRACT: Rotator cuff tear is one of the most common shoulder diseases. It is interesting that some rotator cuff tears are symptomatic, whereas others are asymptomatic. Pain is the most common symptom of patients with a tear. Even in patients with an asymptomatic tear, it may become symptomatic with an increase in tear size. Physical examination is extremely important to evaluate the presence, location, and extent of a tear. It also helps us to understand the mechanism of pain. Conservative treatment often works. Patients with well-preserved function of the supraspinatus and infraspinatus are the best candidates for conservative treatment. After a successful conservative treatment, the symptom once disappeared may come back again. This recurrence of symptoms is related to tear expansion. Those with high risk of tear expansion and those with less functional rotator cuff muscles are less likely to respond to conservative treatment. They may need a surgical treatment.
    Journal of Orthopaedic Science 01/2013; 18(2). DOI:10.1007/s00776-012-0345-2 · 0.94 Impact Factor
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    • "The clinical criteria to diagnose the supraspinatus tendinopathy were a minimum six-month period of painful shoulder and pain on the Jobe [14] or full can tests [15]. The can test consists in evaluating the patient’s ability to resist downward pressure on the arms held at 90° elevation in the scapular plane and 45° external rotation [15]. A screening interview with physical and blood examinations, an X-ray and an MRI of the shoulder were conducted to ensure that the referred patients met the inclusion and exclusion criteria (Table 1) and were willing to participate to the study. "
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    ABSTRACT: There is evidence supporting the use of extracorporeal shock wave therapy (ESWT) in calcific tendinopathy of the rotator cuff, but the best current evidence does not support its use in non-calcifying tendinopathy. We conducted a randomized placebo-controlled trial to investigate the efficacy and safety of low energy ESWT for non-calcifying tendinopathy of the rotator cuff. 20 patients with non-calcifying supraspinatus tendinopathy (NCST) were randomized to an active or a sham treatment group. Physical, blood, roentgenographic, and MRI examinations of the shoulder were conducted to verify that patients met the inclusion and exclusion criteria. These examinations were repeated six and twelve weeks after treatments. Effectiveness was determined by comparison of the mean improvement in the Constant and Murley score (CMS) between the treatment and the placebo groups at three months. Safety was assessed by analyzing the number and severity of adverse events. All the patients completed the investigation protocol. At the final follow-up, significant improvement in the total CMS score and most of the CMS subscales was observed in the ESWT group when compared to the baseline values. Significantly higher total CMS, and significantly higher scores for CMS pain and ROM were observed in the ESWT group when compared to the placebo. No serious adverse events were noted after ESWT. Patients suffering from NCST may benefit from low energy ESWT, at least in short-term. The application protocol of ESWT is likely to play a key-role in a successful treatment. Future investigations should be undertaken on the long-term effects of this technique for the treatment of NCST. Current Controlled Trials ISRCTN41236511.
    BMC Musculoskeletal Disorders 06/2012; 13(1):86. DOI:10.1186/1471-2474-13-86 · 1.72 Impact Factor
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