Digital Public Defence: Martine Enger Martine Enger at Institute of Cinical Medicine will be defending the thesis The epidemiology of shoulder injuries in the general population. Clinical diagnosis of acute rotator cuff tears for the degree of PhD (Philosophiae Doctor).

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Photo: Amalie Huth Hovland, UiO

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

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Adjudication committee

  • First opponent: Professor Antti Malmivaara, Finnish Institute for Health and Welfare, Helsinki, Finland
  • Second opponent: Professor Ville Aärimaa, University of Turku, Finland
  • Third member and chair of the evaluation committee: Professor Hilde Berner Hammer, Institute of Clinical Medicine, University of Oslo

Chair of defence

Professor II John-Anker Zwart, Institute of Clinical Medicine, University of Oslo

Principal supervisor

Professor II Jens Ivar Brox, Institute of Clinical Medicine, University of Oslo


Shoulder complaints are common, and rotator cuff disorders are a major cause.  After acute shoulder injury, patients are normally examined with plain radiographs. Acute rotator cuff tendon tears may therefore be missed. 

The aim of the present project was to provide an epidemiological overview of shoulder injuries in a general population cohort. Furthermore to assess whether physical examination tests may discriminate between patients with and without rotator cuff full-thickness tears in patients with negative radiographs.  

All patients with a suspected shoulder injury attending Department of Orthopaedic Emergency (Oslo skadelegevakt) during one year were registered prospectively. Subsequently, a diagnostic trial including 120 consecutive patients ≥ 40 years with soft tissue shoulder injury was performed. Patients were examined with 13 physical examination tests and ultrasound screening within 3 weeks of the injury. The examiners were blinded to the results of each other. In a subset two physicians performed the tests in order to assess reliability. 

Young men and the elderly over 75 years were at high risk. Injury category varied with age and gender, but the overall proportions in the cohort (n=2650) were 48% soft tissue injuries, 35% fractures and 17% dislocations. A rotator cuff full-thickness tear was diagnosed in 2%. In the population from 6 to 69 years old, 36% of the injuries were sports related. Football, cycling, skiing and martial arts were the most common sports. 

In the diagnostic study, 32% of the patients had a rotator cuff full-thickness tear. The tests with the best diagnostic odds ratio for a tear of the upper rotator cuff were the inability to abduct > 90° and external rotation weakness. Reliability was excellent to moderate. These two simple tests are promising screening tools for the first line services in order to identify patients that should have follow-up and/or referral to advanced imaging like ultrasound or MRI.  

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Published Apr. 13, 2021 2:15 PM - Last modified Apr. 27, 2021 9:42 AM