### Date : 2024-06-16 10:39
### Topic : Shoulder Joint Specific Physical Examination Tests #medicine #orthopedic #physicalexamination
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### Shoulder Joint Physical Examination Tests
#### 1. Sitting Neer Test
The Neer test is used to identify [[Shoulder Impingement Syndrome (충돌증후군)]].
<iframe title="Neer Test | Subacromial Pain Syndrome" src="https://www.youtube.com/embed/bXA8cblZUok?feature=oembed" height="113" width="200" allowfullscreen="" allow="fullscreen" style="aspect-ratio: 1.76991 / 1; width: 100%; height: 100%;"></iframe>
**Positioning:**
- Have the patient sit comfortably with their back straight and arms relaxed by their sides.
**Procedure:**
1. Stand behind the patient.
2. Stabilize the scapula with one hand.
3. With your other hand, internally rotate the patient's arm (thumb pointing down) and then passively flex the shoulder forward, raising the arm overhead.
**Interpretation:**
- Pain during the maneuver indicates a positive Neer test, suggesting subacromial impingement.
#### 2. Hawkins-Kennedy Test
The Hawkins-Kennedy test is another test for shoulder impingement, specifically impingement of the supraspinatus tendon against the coracoacromial ligament and coracoid process.
<iframe title="Hawkins Kennedy Test | Shoulder Impingement" src="https://www.youtube.com/embed/6GkKB2oXi3o?feature=oembed" height="113" width="200" allowfullscreen="" allow="fullscreen" style="aspect-ratio: 1.76991 / 1; width: 100%; height: 100%;"></iframe>
**Positioning:**
- Have the patient sit comfortably with their back straight.
**Procedure:**
1. Stand in front of the patient.
2. Flex the patient's shoulder and elbow to 90 degrees (arm is in front of the patient, elbow bent).
3. With one hand on the elbow and the other hand on the wrist, internally rotate the shoulder by pushing down on the wrist while supporting the elbow.
**Interpretation:**
- Pain during this maneuver indicates a positive Hawkins-Kennedy test, strongly suggesting impingement of the supraspinatus tendon.
#### 3. Empty Can Test
The Empty Can test is used to assess the integrity of the supraspinatus muscle and tendon.
<iframe title="Jobe / Empty Can Test | Subacromial Pain Syndrome (SAPS)" src="https://www.youtube.com/embed/DeO50UTxwoo?feature=oembed" height="113" width="200" allowfullscreen="" allow="fullscreen" style="aspect-ratio: 1.76991 / 1; width: 100%; height: 100%;"></iframe>
<Photo from: https://www.researchgate.net/figure/Schematic-representation-of-the-coracoacromial-ligament-CAL-attachment-on-the-inferior_fig6_322960000>
**Positioning:**
- Have the patient sit or stand with their arms relaxed by their sides.
**Procedure:**
1. Ask the patient to abduct their arms to 90 degrees (straight out to the sides) with the thumbs pointing up.
2. Then, instruct the patient to angle their arms forward about 30 degrees (as if emptying a can), and internally rotate their arms so that their thumbs point downward (like pouring out a can).
3. Apply downward pressure on the patient's arms while they resist.
**Interpretation:**
- Pain or weakness during this maneuver indicates a positive Empty Can test, suggesting **supraspinatus muscle or tendon pathology**, such as a tear or tendinitis.
### Summary
- **Sitting Neer Test:** Identifies subacromial impingement by passively flexing the shoulder with internal rotation.
- **Hawkins-Kennedy Test:** Assesses impingement of the supraspinatus tendon by internally rotating the shoulder at 90 degrees of flexion.
- **Empty Can Test:** Evaluates the integrity of the supraspinatus muscle and tendon by resisting downward pressure with the arms in the scapular plane and thumbs pointing down.