Clinical Examination of the Shoulder

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

 

Shoulder Special Tests — High-Yield Clinical Note

1. Acromioclavicular Joint

Cross-Body Adduction Test

Purpose: assessment of AC-joint pathology.

Position

• Patient standing or sitting upright.
• Arm brought across the body.

Technique

• Examiner pushes the affected elbow further across the body.
• Other hand palpates the AC joint.

Positive test

Pain and tenderness localized to the AC joint.

Exam Pearl

Cross-body adduction – AC joint pathology

2. Subacromial Impingement & Rotator Cuff

The transcript lists the following tests:

Structure / pathology	Test
Subacromial impingement	Neer test
Subacromial impingement	Hawkins test
Rotator cuff tear	Drop-arm test
Subscapularis weakness/rupture	Belly-press test
Subscapularis weakness/rupture	Lift-off test
Infraspinatus	Abduction–external rotation test
Supraspinatus	Jobe test

 

3. Glenohumeral Joint and Labrum

Load-and-Shift Test

Used for:

Glenohumeral instability

Anterior Apprehension Test

Used for:

Anterior instability

Posterior Apprehension Test

Used for:

Posterior instability

Jerk Test

Also used for:

Posterior instability

Sulcus Test

Used for:

Multidirectional instability

4. Biceps Tendon

Speed Test

Used to evaluate:

Biceps tendon pathology

Exam Pearl

Speed test – biceps tendon

5. SLAP Lesion

O’Brien Test

SLAP lesion

Rapid Revision Table

Region	Test	Indicates
AC joint	Cross-body adduction	AC-joint pathology
Subacromial space	Neer	Impingement
Subacromial space	Hawkins	Impingement
Rotator cuff	Drop arm	Rotator-cuff tear
Subscapularis	Belly press	Weakness/tear
Subscapularis	Lift off	Weakness/tear
Infraspinatus	Abduction–ER test	Infraspinatus function
Supraspinatus	Jobe	Supraspinatus function
GH joint	Load and shift	Instability
Anterior instability	Anterior apprehension	Anterior instability
Posterior instability	Posterior apprehension	Posterior instability
Posterior instability	Jerk	Posterior instability
MDI	Sulcus	Multidirectional instability
Biceps tendon	Speed	Biceps pathology
SLAP lesion	O’Brien	SLAP pathology

Exam Pearls

AC joint – Cross-body adduction

Impingement – Neer + Hawkins

Rotator cuff tear-Drop arm

Subscapularis – Belly press + Lift off

Supraspinatus -Jobe

Infraspinatus – Abduction–external rotation

Anterior instability – Apprehension

Posterior instability – Posterior apprehension + Jerk

Multidirectional instability  -Sulcus

Biceps – Speed

SLAP – O’Brien