Shoulder Examination / Subacromial, Cuff - Everything You Need To Know - Dr. Nabil Ebraheim

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Orthopedics

Case description

Dr. Ebraheim’s educational animated video describes the clinical evaluation tests for Shoulder and Rotator Cuff injuries. Neer’s test •Position of the patient: patient is standing or sitting upright. •Performing the tets: the examiner will passively elevate the pronated arm of the patient above the level of the shoulder. •Positive finding: pain at the anterolateral aspect of the shoulder indicates subacromial impingement. Hawkin’s test •position of the patient: patient is standing or sitting upright with the arm fully adducted and forwardly flexed. The elbow is also flexed. •performing the test: the examiner will place one hand on the patient’s shoulder and apply internal rotation to the affected arm with the other hand. •positive findings: pain at the shoulder indicates subacromial impingement. Drop arm test: •position of the patient: patient is standing or sitting upright. •performing the test: the patient is asked to hold the affected arm in abduction at the level of the shoulder then smoothly adduct the arm. •positive findings: a patient who is suffering from a rotator cuff tear can lower the arm smoothly to the side. A patient suffering from a rotator cuff tear will not be able to hold the arm in abduction and the arm will drop rapidly. Belly press test •position of the patient: patient is standing with the hand of the affected arm at rest against the stomach with the elbow anterior to the midaxillary line. •performing the test: the patient is then asked to press the belly using the affected arm without moving the elbow. •positive findings: failure to maintain the elbow anterior to the midaxillary line while pressing against the belly indicates predominantly an infrapsinatus tendon tear. Lift off test •position of the patient: patient is standing with affected arm internally rotated behind the back so that the dorsum of the hand will be resting on the lumbar area. •performing the test: the examiner will passively lift the arm away from the patient’s back. •positive findings: once the examiner releases the arm, failure to maintain the position of the arm away from the back indicates a subscapularis tendon tear. Adduction/external rotation test •position of the patient: patient is standing with the affected arm adducted (slightly abducted) and elbow flexed. •performing the test: the examiner will fully externally rotate the arm. •positive findings: with the release of the arm, failure to maintain active full external rotation indicates a supraspinatus and infraspinatus tendon tear. Jobe test •position of the patient: patient is standing or sitting upright. The arm should be anteriorly flexed at the level of the shoulder. Fully pronate the arm into “empty can position” •performing the test: the patient should resist the downward force applied on the forearm by the examiner. •positive findings: pain or weakness indicates a supraspinatus tendon lesion. 

tags: shoulder examination subacromial cuff orthopedics bone pain


Maciej Dobosz
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Maciej Dobosz

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