In this study of 55 patients, the authors studied five findings and concluded, “The cut point of 3 or more positive of 5 tests can confirm the diagnosis…, while less than 3 positive of 5 rules out.” If you look at the accuracies and the predictive values below, I think you will agree these results are overstated and not very helpful clinically. The shoulder is still very hard to examine.
| Finding | Sensitivity (%) | Specificity (%) | Kappa | Positive predictive value |
Negative predictive value |
|---|---|---|---|---|---|
| Hawkins-Kennedy |
63
|
62
|
.39
|
40
|
61
|
| Neer |
81
|
54
|
.40
|
42
|
13
|
| Painful arc |
75
|
67
|
.45
|
48
|
13
|
| Empty can (Jobe) |
50
|
87
|
.47
|
61
|
19
|
| External rotation resistance |
56
|
87
|
.67
|
64
|
17
|
| 3 or more of 5 findings positive |
75
|
74
|
54
|
12
|
How to do the tests
YouTube videos demonstrating the tests
- Hawkins-Kennedy
- Neer
- Painful arc
- Empty can (Jobe)
- External rotation resistance
This has been added to http://en.citizendium.org/wiki/Shoulder_pain
Citation
Michener LA, Walsworth MK, Doukas WC, & Murphy KP (2009). Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. Archives of physical medicine and rehabilitation, 90 (11), 1898-903 PMID: 19887215
