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The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
Jobe's test is a physical exam test that is used to detect anterior shoulder instability. It is used to distinguish between anterior instability and primary shoulder impingement. This test should be performed after the Apprehension test. [3] This test was named for Christopher Jobe. [4]
[42] [43] The most useful single test for infraspinatous tendon tears is the drop sign (the examiner lifts the arm straight out from the body with the palm up, the person then needs to hold it there for 10 seconds) and the external rotation lag sign (with the arm by the side and the elbow bent to 90 degrees the person tries to rotate outwards ...
On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test). These tests help localize the pathology to the rotator cuff; however, they are not specific for impingement. [16] Neer sign may also be seen with subacromial bursitis. [17]
The Hawkins-Kennedy test [11] [12] has a sensitivity of approximately 80% to 90% for detecting impingement. The infraspinatus and supraspinatus [13] tests have a specificity of 80% to 90%. [10] A common cause of shoulder pain in rotator cuff impingement syndrome is tendinosis, which is an age-related and most often self-limiting condition. [14]
A positive Hawkins–Kennedy test is indicative of an impingement of all structures that are located between the greater tubercle of the humerus and the coracohumeral ligament. The impinged structures include the supraspinatus muscle, teres minor muscle , and the infraspinatus muscle .
This is a difficult test to perform for an accurate diagnosis. [2] False positive findings can be the result of a rotator cuff tear, while pain in the superior glenohumeral region is a weak predictor of a SLAP tear. [4]