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A 50 year-old female presents with a complaint of severe pai…

A 50 year-old female presents with a complaint of severe pain in her right eye which has progressed over the past 2 days. She also complains of moderate photophobia. She has no complaints to the left eye. PMH is significant for recent diagnosis of rheumatoid arthritis. She does not wear corrective lenses, her last visit to the optometrist was 6 months ago and she states her vision then was “20/20 in both eyes”. PE reveals vision 20/20 OS and 20/200 OD, left pupil is round and reactive to light, right pupil is round and reactive but constricted. There is circumcorneal injection involving the right eye. The anterior chamber depth is normal bilaterally, corneas are clear bilaterally and the fundoscopic exam is WNL bilaterally. Your differential diagnosis of this patient would include all of the following EXCEPT?

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Here is an excerpt from a diagnostic study by Sgori et al. (…

Here is an excerpt from a diagnostic study by Sgori et al. (2018) titled: Diagnostic Value of Clinical Tests for Supraspinatus Tendon Tears   All patients were then preoperatively examined in our outpatient sports medicine clinic by 2 orthopaedic surgeons specialized in sports orthopedics. The examiners were blinded and were given no information about the diagnosis and upcoming operation for each patient. During the clinical examination, the supraspinatus tendon was evaluated using 7 clinical tests: the empty can test, the full can test, the zero-degree abduction test, the Whipple test, the scapular retraction test, the drop arm test, and the modified drop arm test. All patients underwent arthroscopy of the shoulder during which the supraspinatus tendon was examined from the articular as well as the bursal side and pathologies were treated, if necessary. In all cases, the decision to perform arthroscopy was made previously, in a blinded fashion and independently from the study. All arthroscopies were performed by 2 board-certified orthopaedic surgeons specialized in shoulder surgery. In order to avoid overestimating the results, the surgeons who performed the arthroscopic examination were blinded to the results of the clinical tests and other diagnostic testing. The clinical examiners and the surgeons were not the same. In order to assess the sensitivity, positive predictive value, negative predictive value, accuracy, diagnostic odds ratio, positive and negative likelihood ratio, and the area under the curve of the tests, the intraoperative findings were compared with the results of the clinical examination.   You are appraising this study to determine whether you should use it to answer your foreground question: “In individuals with suspected rotator cuff tears, what clinical test is most effective at identifying rotator cuff tears?”     Provide 3 factors that are related to the excerpt that would influence your appraisal of the quality of this diagnostic study.  Indicate how it would influence your decision-making process (3 points per factor for a total of 9 points).

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