Shoulder injuries are the second most common workplace injury in many states. Between January 2011 and June 2012 there were 1,990 shoulder injury awards, amounting to over $50.5 million paid to workers in a single state. Common tasks with repetitive motion such as painting walls, hanging curtains, repairing vehicles raised on a lift, filing, and lifting objects increase the risk for shoulder injuries due to excessive overhead arm motion. What do all these tests mean in medical reports?
Tests Used in Shoulder Evaluation and Significance of Positive Findings According to American Association of Family Physicians
Test Maneuver Diagnosis suggested by positive result
Apley scratch test Patient touches superior and inferior aspects of opposite scapula Loss of range of motion: rotator cuff problem
Neer’s sign Arm in full flexion Subacromial impingement
Hawkins’ test Forward flexion of the shoulder to 90 degrees and internal rotation Supraspinatus tendon impingement
Drop-arm test Arm lowered slowly to waist Rotator cuff tear
Cross-arm test Forward elevation to 90 degrees and active adduction Acromioclavicular joint arthritis
Spurling’s test Spine extended with head rotated to affected shoulder while axially loaded Cervical nerve root disorder
Apprehension test Anterior pressure on the humerus with external rotation Anterior glenohumeral instability
Relocation test Posterior force on humerus while externally rotating the arm Anterior glenohumeral instability
Sulcus sign Pulling downward on elbow or wrist Inferior glenohumeral instability
Yergason test Elbow flexed to 90 degrees with forearm pronated Biceps tendon instability or tendonitis
Speed’s maneuver Elbow flexed 20 to 30 degrees and forearm supinated Biceps tendon instability or tendonitis
"Clunk" sign Rotation of loaded shoulder from extension to forward flexion Labral disorder