Shoulder Physical Exam Tests: Difference between revisions

Revision as of 05:38, 22 February 2012

Rotator Cuff Tests

Supraspinatus Test
- Abduct arm to 90', forward flex it 30' w/ thumb down ("empy beer can position")
- Test for pain/weakness against resistance to continued abduction
Infraspinatus and Teres Minor Test
- Stabilize the elbow against the pt's waist and bend the elbow to 90'
- Test for pain/weakness against resistance to external rotation
Subscapularis Test
- Place hand behind lower back
- Test for pain/weakness as pt attempts to push examiner's hand away by moving dorsum of hand away from back

Impingement Tests

Maneuver of Neer
- Prevent scapular rotation w/ one hand while rasing pt's straightened arm in full forward flexion to overhead
- Positive sign is pain in the arc bewtween 70-120'
Hawkins Impingement Test
- Position the shoulder at 90' of abduction and elbow at 90' of flexion
- Then rotate shoulder internally bringing the arm across the front of the pt
- Positive sign is pain during this maneuver

Source

Tintinalli

Authors:

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-==Background==
+==Rotator Cuff Tests==
+*Supraspinatus Test
+**Abduct arm to 90', forward flex it 30' w/ thumb down ("empy beer can position")
-With arms out to side at 90 deg:
+**Test for pain/weakness against resistance to continued abduction
+*Infraspinatus and Teres Minor Test
-Internal rotation --> drops hand forward
+**Stabilize the elbow against the pt's waist and bend the elbow to 90'
+**Test for pain/weakness against resistance to external rotation
-External rotation --> raises hand up (like testifying in court)
+*Subscapularis Test
+**Place hand behind lower back
+**Test for pain/weakness as pt attempts to push examiner's hand away by moving dorsum of hand away from back
+==Impingement Tests==
-==Impingement signs==
+*Maneuver of Neer
+**Prevent scapular rotation w/ one hand while rasing pt's straightened arm in full forward flexion to overhead
+**Positive sign is pain in the arc bewtween 70-120'
-(pain with)
+*Hawkins Impingement Test
+**Position the shoulder at 90' of abduction and elbow at 90' of flexion
--passive forward elevation
+**Then rotate shoulder internally bringing the arm across the front of the pt
+**Positive sign is pain during this maneuver
--internal rotation with arm abducted 90 degrees
--external rotation with arm abducted at 90 degrees,
--adduction
-==Positive drop arm test==
--pt holds outstretched arm at 90 degrees of abduction, doc pushes down at wrist
--arm drop signifies weakness secondary to rotator cuff tear
--pain without weakness suggests subacromial bursitis or supraspinatus tendinitis
 ==Source==
+*Tintinalli
-/07 DONALDSON (adapted from Miller, Mistry)
 [[Category:Ortho]]