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| == Purpose<br> == | | == Purpose<br> == |
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| This test is commonly used to identify possible [[Impingement Syndromes|subacromial impingement syndrome]].<br>
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| == Technique<br> == | | == Technique<br> == |
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| The examiner first places the patient's shoulder in 90 degrees of flexion with the elbow flexed to 90 degrees, and then internally rotates the arm. The test is considered to be positive if the patient experiences pain with internal rotation.<ref>Flynn, T.W., Cleland, J.A., &amp; Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion</ref> <br>
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| {{#ev:youtube|2mSv7gLXyYg|300}}
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| | <ref>online video, http://www.youtube.com/watch?v=2mSv7gLXyYg&amp;feature=channel, last accessed 1/22/09</ref>
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| == Evidence == | | == Evidence == |
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| {| cellspacing="1" cellpadding="1" border="1" style="width: 380px; height: 129px;"
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| |+ Diagnostic Test Properties for Hawkins-Kennedy Impingement Sign <ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref> fckLR|-fckLR| Sensitivity fckLR| .62 - .92fckLR|-fckLR| Specificity fckLR| .25 - 1.00fckLR|-fckLR| Positive Likelihood Ratio fckLR| 1.20 - 3.33fckLR|-fckLR| Negative Likelihood Ratio fckLR| .21 - .55fckLR|}fckLRfckLR&lt;br&gt;
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| <br> When this test is combined as a cluster with the [[Painful Arc|Painful Arc Sign]] and the [[Infraspinatus Muscle Test|Infraspinatus test]], and all three tests report a positive, then the positive likelihood ratio is 10.56 and if all three tests are negative, the negative likelihood ratio is .17. If two of the three tests are positive, then the positive likelihood ratio is 5.03.&lt;ref&gt;Park, H.B., Yokota, A., Gill, H.S., EI RG, McFarland, E.G. (2005). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am, 87(7), 1446-1455.</ref> <br> <br>
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| == References<br> == | | == References<br> == |
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