What is Hornblower sign?

The patient is asked to bring the hands to the mouth. He can do it, but only with the elbow in a high position and the wrist in extension on the affected side (right arm). On the intact side (left arm), the patient can reach the mouth without bringing the elbow high.

How do you test the infraspinatus muscle?

Technique. The patient arms should be at his side not quite touching his trunk, with the elbows flexed to 90 degrees. The examiner places his hand on the dorsum of the patient’s hands. The patient is asked to externally rotate both forearms against the examiner’s resistance.

What does subscapularis pain feel like?

The most common symptom of a subscapularis tear is shoulder pain, especially in the front of the shoulder. You might also hear or feel “clicking” in your shoulder when you rotate your arm. Some symptoms of a subscapularis tear are very similar to symptoms of other rotator cuff tears.

What movement does subscapularis do?

The subscapularis rotates the head of the humerus medially (internal rotation) and adducts it; when the arm is raised, it draws the humerus forward and downward. It is a powerful defense to the front of the shoulder-joint, preventing displacement of the head of the humerus.

What is positive Neer sign?

Neer [27, 28] described a diagnostic sign for impingement performed by passively flexing the patient’s arm until pain is felt in the anterior or anterolateral proximal arm. According to Bigliani and Levine [3], a positive impingement sign typically occurs with the arm between 70° and 120° flexion.

What is Paxinos sign?

The examiner provides pressure to the acromion in an anterosuperior direction with the thumb, while also applying pressure an inferior direction to the mid-clavicle with the index and middle fingers. If pain is elicited or increased in the region of the acromioclavicular joint, the test is considered positive.

What movement does the infraspinatus perform?

When the shoulder is held in anatomic position, the infraspinatus allows the abduction of the inferior angle of the scapula, termed scaption. Scaption makes the scapula more mobile, which assists the other shoulder muscles in allowing for full shoulder abduction.

What is the sensitivity of the lag sign?

A cohort study has concluded that the Lag Sign has a sensitivity of 97% and a specificity of 93% for full thickness tairs of the infraspinatus muscle. A sensitivity of 100% and a specificity of 93% for full thickness tears of the teres minor muscle.

Is the external rotation lag sign a valid test?

The External Rotation Lag Sign (ERLS), described by Hertel et al in 1996, has been widely accepted as a valid test for the diagnosis of tears involving at least the infraspinatus muscle. More recently, the test has been re-evaluated.

What does the lag sign of the shoulder mean?

The patient is then asked to maintain the position actively while the examiner releases the wrist while maintaining support through the elbow. An inability to maintain the position (lag) would suggest a full-thickness tear of the rotator cuff. The magnitude of the lag is recorded in degrees to the nearest 5°.