Diagnostic Accuracy of the Royal London Hospital Test and Painful Arc Test in The Diagnosis of Achilles Tendinopathy

Abstract

Achilles tendinopathy (AT) is a common musculoskeletal disorder characterized by pain and functional impairment. The Royal London Hospital Test (RLHT) and Painful Arc Test are non-invasive physical examinations for detecting AT. However, the use of these two diagnostic tools in Indonesia remains limited. This study aims to evaluating the diagnostic accuracy of the RLHT and Painful Arc Test for diagnosing AT. This cross-sectional diagnostic study involved individuals with Achilles tendon pain who met the study criteria. Subjects underwent the RLHT and Painful Arc tests by independent examiners, with ultrasonography as the reference standard. Analysis included sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy. A total of 44 subjects were enrolled; based on ultrasonography, 30 subjects (68.2%) were diagnosed with AT and 14 subjects (31.8%) were normal or non- AT. The RLHT demonstrated a sensitivity of 86.67% and a specificity of 57.14%, with an overall accuracy of 77.3%, while the Painful Arc Test demonstrated a sensitivity of 90.00% and a specificity of 57.14%, with an overall accuracy of 79.5%. In conclusion, the RLHT and the Painful Arc Test demonstrated high sensitivity, supporting their use as screening tools for Achilles tendinopathy