PCMI Shoulder Special Test Flashcards
Apprehension Test
Glenohumeral Instability
+ sign = pt apprehension or pain
Set-up: Patient is seated or supine. Shoulder abducted to 90° and elbow flexed to 90°. Stabilize shoulder with one hand (blocking linkage) and force arm into external rotation with the other hand
Sulcus Sign
Glenohumeral Instability
+ sign = Indention appears in area
beneath the acromion (Paul’s Shoulder)
Set-up:
Grasp patient’s elbow and apply
inferior traction
Yergason’s Test
Bicipital Tendon Pathology
+ sign = Pain and/or tendon
subluxation out of groove
Indicates: Unstable bicipital Tendon
Set-up: Patient's arm at side with elbow flexed to 90°. Physician uses one hand to palpate bicipital groove and monitors there, while the other hand grasps the patient's wrist. Have patient supinate and externally rotate against physician's resistance.
Speed’s Test
Bicipital Tendon Pathology
+ sign = Pain and/or tendon
subluxation out of groove
Indicates: Unstable bicipital Tendon
Set-up: Patient's arm at side with elbow flexed to 90°. Physician uses one hand to palpate bicipital groove and monitors there, while the other hand grasps the patient's wrist. Have patient supinate and externally rotate against physician's resistance
Speed’s Test
Bicipital Tendon Pathology
+ sign = Pain in bicipital groove
Indicates: Bicipital tendonitis
of longhead biceps
Set-up: Patient's arm flexed (50°-90°) at the shoulder with hand supinated. Slightly flex patient's elbow. Resist at forearm while patient flexes shoulder.
Empty Can Test
Rotator Cuff Pathology
+ sign = Pain or weakness
Indicates: Rotator cuff pathology
(specifically supraspinatus)
Set-up: Flex patient's shoulders to 90° while horizontally abducting to 45°. Then internally rotate both arms so thumbs are pointing down. Press down on forearms while patient resists.
Drop-Arm Test
Rotator Cuff Pathology
+ sign = Arm will drop or gentle
tap on wrist will cause arm to
drop
Indicates: Full thickness tear of
supraspinatus
Set-up:
Patient abducts arm to 90°, then
slowly drops arm
Painful Arc Test
Rotator Cuff Impingement
+ sign = Pain is elicited within 60 and
120 degrees of shoulder abduction.
Indicates subacromial impingement
and /or rotator cuff injury
Set-up:
Patient abducts arm starting at their
side.
Neer Impingement
Rotator Cuff Impingement
+ sign = pain
Indicates: Subacromial bursa or
rotator cuff impingement
Stabilize patient’s shoulder. With
forearm pronated, passively flex
shoulder to fully flexed position.
Hawkins Test
Rotator Cuff Impingement
+ sign = pain
Indicates: Rotator cuff or
subacromial bursa impingement
Set-up: Flex shoulder to 90°, flex elbow to 90°, and passively rotate the humerus into internal rotation. This opposes rotator cuff against coracoacromial ligament and acromion
Lift Off Test
Subscapularis
+ sign = Weakness (inability to resist)
Indicates: Subscapularis weakness
Set-up:
Place patient’s arm into internal rotation and
extension. Patient pushes arm into further
internal rotation as physician resists
Cross Arm Test
Acromioclavicular
+ sign = Pain in AC joint with end range
adduction
Indicates: AC joint pathology
Set-up:
Physician passively adducts patient’s arm across
their chest and rests patient’s hand on their opposite
shoulder.
Apley Scratch Test
Range of Motion
Physician should make note of how far the
patient can reach.
Upper: patient abducts arm placing palm of hand
behind their neck with palm facing toward the body.
Patient should attempt to scratch the lowest possible
vertebrae (coupled external rotation and abduction)
Lower: patient places arm behind their back with
palm facing outward and dorsum of hand resting on
their mid-back. Patient should attempt to scratch the
highest possible vertebrae (coupled internal rotation
and adduction)
