Which exam test is most sensitive for detecting a rotator cuff tear?

Which exam test is most sensitive for detecting a rotator cuff tear?

• A. Drop arm test
• B. Neer sign
• C. Empty can (Jobe) test
• D. Hawkins-Kennedy test

Answer: (C)

Understanding how to detect a rotator cuff tear relies on tests that isolate the supraspinatus tendon. The empty can (Jobe) test does this by placing the arm in the scapular plane with internal rotation (thumb down) and having the patient resist an upward force. If the supraspinatus tendon is torn, weakness or pain appears, making this test the most sensitive way among common maneuvers to pick up a tear. Other tests are helpful but less sensitive for tears specifically. The drop arm test emphasizes the ability to hold the arm up and is more about detecting larger, full-thickness tears. Neer sign and Hawkins-Kennedy provoke impingement symptoms and can be positive with various shoulder problems, not only tears, so they don’t isolate the torn tendon as effectively.

Understanding how to detect a rotator cuff tear relies on tests that isolate the supraspinatus tendon. The empty can (Jobe) test does this by placing the arm in the scapular plane with internal rotation (thumb down) and having the patient resist an upward force. If the supraspinatus tendon is torn, weakness or pain appears, making this test the most sensitive way among common maneuvers to pick up a tear.

Other tests are helpful but less sensitive for tears specifically. The drop arm test emphasizes the ability to hold the arm up and is more about detecting larger, full-thickness tears. Neer sign and Hawkins-Kennedy provoke impingement symptoms and can be positive with various shoulder problems, not only tears, so they don’t isolate the torn tendon as effectively.